ONE HUNDRED YEARS OF MILES’ OPERATION- WHAT HAS CHANGED?

• Main Authors: Vanja Pecić, Dragan Mihajlović, Branko Branković, Dragoslav Miljković, Goran Stanojević, Dejan Petrović, Milica Nestorović
• Format: Article
• Language: English
• Published: University in Nis, Faculty of Medicine 2008-12-01
• Series: Acta Medica Medianae
• Subjects: William Ernest Miles; abdominoperineal resection; rectal cancer
• Online Access: http://publisher.medfak.ni.ac.rs/2008-html/4-broj/ONE%20HUNDRED%20YEARS%20OF%20MILES....pdf

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%.