A procedure of the pull-through type, called descriptively a combined abdominoendorectal resection, has been used in the surgical service of one of us (B. M. B.) since 1948. It differs from the usual sphincter-saving operation in that the most distal 3 to 4 cm. of rectum is preserved instead of the sphincter only. While the technical modification is relatively minor, subsequent fecal control is thereby improved greatly. Experience (through 1956) with the procedure in the treatment of 106 patients with carcinoma, 5 with benign polypoid lesions, 2 with megacolon, and 1 with segmental chronic ulcerative colitis forms the basis for the present report.
The technical aspects of the operation have been described in detail previously,3,4 and only certain features and changes that have been made in the technique will be considered at this time. The abdominal part of the procedure is identical with that of sphincter-saving operations,