Perineal dissection of synchronous abdominoperineal resection of the rectum: An anatomical description

Vijay P. Khatri, Miguel A. Rodriguez-Bigas, Nicholas J. Petrelli

Research output: Contribution to journalArticle

6 Scopus citations


Abdominoperineal resection (APR) has remained the gold standard for management of distal rectal adenocarcinoma since the original description by W. Ernest Miles in 1908. The classic Miles procedure involved a 1-team approach: after the initial abdominal mobilization of the rectosigmoid colon, the patient was placed in the left lateral position for the perineal proctectomy. Lloyd-Davies described the currently popular synchronous, combined approach in 1939 after Devine introduced adjustable stirrups to place the patient in the lithotomy position. Several modifications of the Lloyd-Davies APR procedure have been described through the years, but the basic principles espoused by Miles remain unchanged.

Original languageEnglish (US)
Pages (from-to)553-559
Number of pages7
JournalArchives of Surgery
Issue number5
StatePublished - May 1 2003


ASJC Scopus subject areas

  • Surgery

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