The choice of offensive against cancer of the rectum and rectosigmoid at the present time indubitably is surgical intervention. That the extirpation of cancer in this location can be done in conformity with the fundamental principles of radical operations for cancer elsewhere is equally true. It is axiomatic, however, that cancers low in the gastrointestinal tract demand an unusually high individualization so far as operative maneuvers are concerned. No one technical procedure is applicable to all malignant growths in this location, and many factors, including coexisting debilitating diseases, the ability of the patient to withstand formidable surgical intervention and the undermining influences of malignant processes in general must influence the choice of operation.
The well known tendency of cancers of the rectum to develop on adenomas and areas of local hyperplasia, the slow evolution of the concurring malignant process, its tendency to be of a relatively low order of cellular