Acta Medica Medianae
Klinika za hirurgiju Kliničkog centra
Bul. dr Zorana Đinđića 48
18000 Niš, Srbija
Copyright 2008 by Faculty of Medicine, University of Nis
From history of medicine
ONE HUNDRED YEARS OF MILES’ OPERATION- WHAT HAS CHANGED?
Milica Nestorović, Dejan Petrović, Goran Stanojević, Dragoslav Miljković, Dragan Mihajlović, Branko Branković i Vanja Pecić
Lisfranc was probably the first to excise the rectum for cancer. He performed operation using perineal approach in 1826. This operation came into common use fifty years later. Czerny did the first combined abdominoperineal resection in attempt to finish excision he could not complete from below. Some fifteen years later Ernest Miles described the planned, one stage abdominoperineal resection.
Miles name has become a synonym for this combined procedure, creating a radical change in the philosophy of resection and en bloc lymphadenectomy.
In the beginning of twenty-century abdominoperineal resection became golden standard in the treatment of rectal cancer. Reconstructive operations, introduction of stapling devices and better understanding of potential tumor spread, reduced indications for Miles operation.
Surgical treatment of rectal cancer made progress in the past 100 years. Miles was the first in line. Without his theory of perirectal lymphatic spread recurrence rate would be still as high as 95%. Acta Medica Medianae 2008;47(4):43-46.
Key words: William Ernest Miles, abdominoperineal resection, rectal cancer