The frequency and sites of carcinoma of the sigmoid colon and rectum are discussed. The complications associated with Dixon's anterior resection of the rectum are described, with particular reference to factors affecting cicatrisation of the colic anastomoses, followed by dehiscences and their degree of seriousness. A personal serier for the years 1969 to 1975 is presented and the advantages and disadvantages of derivative colostomy are explained. Comparison with similar series in which colostomy was or was not employed is used to elicit the reasons why it may be regarded as superfluous.

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