THE ADVANTAGE OF PERINEAL OVER ABDOMINAL COLOSTOMY:  WITH TECHNIC FOR TRANSFERRING THE ABDOMINAL OPENING TO THE PERINEUM

In 1930, having observed marked advantages of a perineal colostomy in resections of the pelvic colon, I eliminated a permanent abdominal opening in any case in which the lesion was considered surgically removable. Since this change in technic 220 patients with cancer of the large intestine have been treated by operation. In twenty-six instances the disease was so advanced that only an exploration or colostomy was done. In 103 the rectosigmoid was resected with the formation of a perineal anus but without sphincter control. After the first three or four months of adjustment these patients have been very appreciative of the perineal opening, quite different from the attitude of many who have been left with an abdominal colostomy. An abdominal colostomy necessitates a pad or other protection. With an adequate perineal opening, although without sphincter control, 5 per cent of my patients require no local protection, special diet or other