Three hundred and twenty two cases of rectal cancer, operated in our hospital from 1946 to 1960, . were reviewed statistically.
The coexistence of cancer and adenomatous polyps is very common in colon and rectum, and malignant change of polyps is not rare. Polyps are the most important lesions as the etiological factor. Cancer caused from the lesion of shistosomiasis is not frequent at present, and also cancer from the chronic colitis is rare in Japan. Though the most cases of rectal cancer had rather manifest symptoms in early stadium, they were often misdiagnosed and the chance of cure was often missed.
As for the most part of our cases, radical operation with anus preternaturalis has been adopted. but, the recent progress in surgery, the clinico-pathological studies on the spread of rectal cancer and the increase of early stage operative cases are amplifying the indication for radical operation with natural anus. The-rate of curative operation (80%) and 5-year survival rate (57%) of rectal cancer are both high, because-the grade of malignancy is lower in rectal cancer than in gastric cancer. Sex and age of the patients, and character and stage of the cancer brought influence on the results of the treatment. The 5-year survival rate in group with lymphnode metastasis is 43% and without metastasis 78%; in Dukes' A, B, C1, and C2, are respectively 83%, 78%, 48% and 28%. (Author's abstruct)

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Low residue diet and non residue diet as a preoperative treatment for colonic surgery are very important from the view point described below.
1. Faciliation of surgical operation.
2. Faciliation of palpation to detect lesions inside colon. Especially on the detection of colonic polyp. 3. Prevention of postoperative bowel paralysis.
4. Prevention of suture insufficiency, associating with preoperative bowel sterilization.
5. Prevention of fecal contamination
Here the author tried to make Japanese style low residue diet. Applying it to 10 surgical colonic cases, good result was obtained. (Author's abstract)

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This is a report of 144 cases of the anorectal diseases admitted at the surgical department of the Shinshu University Hospital from Jan. 1953 to Dec. 1960. There were 34 cases (23.6 %) of rectal carcinoma occupying 65 per cent of the carcinomas occured in the colon. The symptoms which may be considered as suggestive were not uniform, so that early diagnosis were occasionally missed, such as hemorrhoids (15 cases), proctitis (2), anal polyp (1), colitis (2), ulcerative colitis (1) and gastric diseases (2). Since long years the resection of the rectal carcinoma had been performed by abdominoperineal procedure (Miles operation) and the gauze pack inserted into the large cavity through the perineal wound. Since 1954 the authors have tried to close the perineal wound as primarily as possible. Consequently, the term of the healing of the perineal wound was shortened to 27 days, while in former times it took 72 days to heal up.

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Three cases of rectal stricture, 47 aged male, 52 aged female and 40 aged male, were diagnosed as rectal carcinoma. One stage abdomino-perineal resection was done in one case and two stage operation in others. Their histologic findings showed nonspecific chronic inflammation and there were no malignancies. Differentiation from ulcerative colitis or venereal lymphogranuloma could not be cleared because of some erosion of mucous membrane, fibric hyperplasia of the wall and infiltration of small round cells and no performance of Frei test.

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30 cases of pruritus ani which could not be cured by various medicament, were treated by local injection of Predonin accomplished satistactory results. The treatment was as follows : 0.5-1.0 cc of Pre-donin with same dosage of 0.5 per cent solution of Procain hydrochloride was injected into the affected perianal skin intracutaneously, once or twice, occasionally three times, at four to eight days interval. After which the affected area was covered by a wet pack of Rivanol-solution, or some oinment contained boracic zinc or antihistamin preparation. Iching disappeared usually in five to six hours, at the longest in few days.

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There were 99 hemorrhoidectomies by Whitehead' procedure in the past 6 years and 49 cases of them were discussed about the results from the long-term observations based on enquetes. The postopertive disturbances are as follows: each 8 per cent of mucous membrane prolaps, anal pain at stool and anal incontinence, 10 per cent of anal bleeding at stool and 14 per cent anal stricture. These disturbances were not so severe that the reoperation had to undertake. Although there were 52 per cent of cases who had not complained about these disturbances, it seems that the indications for Whitehead' procedure as a treatment of hemorrhoid schould be more strict.

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