LETTERS TO THE EDITOR
Missing Data or Not? To the Editor—We read Aly’s editorial1 with interest. The author commented that some studies did not report important information that should be included.1 As an example, the author pointed out that our previous study2 on complications of robotic rectal cancer surgery did not include the length of hospital stay in our results. However, we reported in Table 3 that the mean length of hospital stay was 17.6 days in the complication group and 8.7 days in the noncomplication group. REFERENCES 1. Aly EH. The need for standardized international reporting criteria on postoperative outcomes in rectal cancer surgery. Dis Colon Rectum. 2013;56:1434–1437. 2. Kang J, Min BS, Park YA, et al. Risk factor analysis of postoperative complications after robotic rectal cancer surgery. World J Surg. 2011;35:2555–2562.
Jeonghyun Kang, M.D. Kang Young Lee, M.D., Ph.D. Seoul, Korea Dis Colon Rectum 2015; 58: e1 DOI: 10.1097/DCR.0000000000000258 © The ASCRS 2014
Julius Von Hochenegg Published the Pull-Through Method for Rectoanal Reconstruction 125 Years Ago To the Editor—The coloanal anastomosis is currently a standard reconstruction after an ultralow rectal resection. Although many think of the coloanal pull-through anastomosis as a recent innovation, the basic idea of this technique has quite a long history. Julius von Hochenegg was the first to publish 1 version of this technique in 1889.1 In the 19th century, rectal cancers were resected from the perineal or sacral route to avoid a laparotomy.
Diseases of the Colon & Rectum Volume 58: 1 (2015)
This kind of rectal resection resulted always in a perineal colostomy, which was very difficult to manage. Hochenegg was very concerned about the poor quality of life of these patients. In 1887, he performed the first successful sphincter-saving rectal resection in a 32-year-old woman.2 Because an end-to-end anastomosis between the rectal stump and the colon was prone to disruption with fatal complications, Hochenegg was looking for a safer method that could stabilize the connection between the 2 bowel ends. He described a technique where the mucosa of the lower rectum and anal canal was removed and then the colon was pulled through the anus and fixed externally with interrupted sutures. A second row of sutures was put between the upper end of the anal canal and the colon. He called this method the Durchzieh method: the pull-through method. In his institution, the University Clinic of Surgery II of Vienna, he collected a series of 1704 rectal cancers. Of these rectal cancers, 1000 had a sacral resection with a mortality of 11%, 45% from sepsis. The pull-through method was applied in 24% of the resections. Fecal continence was maintained in 60%.3 The Durchzieh method represented a real advance in rectal cancer surgery. In addition to the maintenance of continence, the advantages of the method included the avoidance of such severe complications as anastomotic leak, sacral fistulas, and bowel prolapse. REFERENCES 1. Hochenegg J. Beiträge zur Chirurgie des Rektums und der Beckenorgane. WienKlinWschr 1889;29:578–802. 2. Hochenegg J. Die sakrale Methode der Exstirpation von Mastdarmkrebsen nach Prof. Kraske. Wien KlinWschr 1888;I:324–326. 3. Mandl F. Über 1000 sakrale Mastdarmkrebsexstirpationen (aus dem Hocheneggschen Material). Dt Zschr f Chir 1929;219:3–40.
Rudolf Schiessel, M.D. Jasming, Austria Dis Colon Rectum 2015; 58: e1 DOI: 10.1097/DCR.0000000000000276 © The ASCRS 2014
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Missing Data or Not? To the Editor—We read Aly’s editorial1 with interest. The author commented that some studies did not report important information that should be included.1 As an example, the author pointed out that our previous study2 on complications of robotic rectal cancer surgery did not include the length of hospital stay in our results. However, we reported in Table 3 that the mean length of hospital stay was 17.6 days in the complication group and 8.7 days in the noncomplication group. REFERENCES 1. Aly EH. The need for standardized international reporting criteria on postoperative outcomes in rectal cancer surgery. Dis Colon Rectum. 2013;56:1434–1437. 2. Kang J, Min BS, Park YA, et al. Risk factor analysis of postoperative complications after robotic rectal cancer surgery. World J Surg. 2011;35:2555–2562.
Jeonghyun Kang, M.D. Kang Young Lee, M.D., Ph.D. Seoul, Korea Dis Colon Rectum 2015; 58: e1 DOI: 10.1097/DCR.0000000000000258 © The ASCRS 2014
Julius Von Hochenegg Published the Pull-Through Method for Rectoanal Reconstruction 125 Years Ago To the Editor—The coloanal anastomosis is currently a standard reconstruction after an ultralow rectal resection. Although many think of the coloanal pull-through anastomosis as a recent innovation, the basic idea of this technique has quite a long history. Julius von Hochenegg was the first to publish 1 version of this technique in 1889.1 In the 19th century, rectal cancers were resected from the perineal or sacral route to avoid a laparotomy.
Diseases of the Colon & Rectum Volume 58: 1 (2015)
This kind of rectal resection resulted always in a perineal colostomy, which was very difficult to manage. Hochenegg was very concerned about the poor quality of life of these patients. In 1887, he performed the first successful sphincter-saving rectal resection in a 32-year-old woman.2 Because an end-to-end anastomosis between the rectal stump and the colon was prone to disruption with fatal complications, Hochenegg was looking for a safer method that could stabilize the connection between the 2 bowel ends. He described a technique where the mucosa of the lower rectum and anal canal was removed and then the colon was pulled through the anus and fixed externally with interrupted sutures. A second row of sutures was put between the upper end of the anal canal and the colon. He called this method the Durchzieh method: the pull-through method. In his institution, the University Clinic of Surgery II of Vienna, he collected a series of 1704 rectal cancers. Of these rectal cancers, 1000 had a sacral resection with a mortality of 11%, 45% from sepsis. The pull-through method was applied in 24% of the resections. Fecal continence was maintained in 60%.3 The Durchzieh method represented a real advance in rectal cancer surgery. In addition to the maintenance of continence, the advantages of the method included the avoidance of such severe complications as anastomotic leak, sacral fistulas, and bowel prolapse. REFERENCES 1. Hochenegg J. Beiträge zur Chirurgie des Rektums und der Beckenorgane. WienKlinWschr 1889;29:578–802. 2. Hochenegg J. Die sakrale Methode der Exstirpation von Mastdarmkrebsen nach Prof. Kraske. Wien KlinWschr 1888;I:324–326. 3. Mandl F. Über 1000 sakrale Mastdarmkrebsexstirpationen (aus dem Hocheneggschen Material). Dt Zschr f Chir 1929;219:3–40.
Rudolf Schiessel, M.D. Jasming, Austria Dis Colon Rectum 2015; 58: e1 DOI: 10.1097/DCR.0000000000000276 © The ASCRS 2014
e1
