Fifty years of cancer surgery of the large intestine at Osaka University Hospital.

Surgical procedures were performed in 863 cases of carcinoma of the large intestine in the Second Department of Surgery, Osaka University Hospital, Japan, between 1924 and 1973. There were 262 cases (30.3%) of carcinoma of the colon and 601 cases (69.7%) of carcinoma of the rectum. Sacral resection was the main procedure for rectal carcinoma until 1934. From 1954 through 1962, the abdominoperineal excision became predominant with radical operability 73.3%. Operative mortality declined to 2.3% and the five-year survival rate reached 52.1%. In 1963, sphincter-preserving operations were introduced, after which the radical operability increased to 76.1% and the survival rate to 56.8%. In these years, we selected cases for low anterior resection. Welch's invagination anastomosis and Bacon's pull-through operation according to each indication. For colonic carcinoma, the operative mortality was 2.2%, the five-year survival rate 63.2% and the ten-year survival rate 44.2% in the last period.