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In the past few years a voluminous literature has appeared on the subject of stricture of the rectum secondary to lymphogranuloma venereum. Almost without exception, however, the treatment of this condition has been dealt with superficially and briefly. The obvious reason for this has been the inadequacy of all forms of treatment instituted. An utter feeling of despair has arisen in both patient and physician, so that permanent colostomy has been accepted as the procedure of choice. What a high price this is for the young adult afflicted with an otherwise benign condition that can be reached with the finger! And no hope was entertained by these patients of ever having these colostomies closed after any local form of treatment to the strictured areas. Ault 1 in his review of venereal diseases of the rectum states that "No permanent cure of stricture due to lymphogranuloma venereum has been reported to

Not too infrequently incisional hernias occur about a permanent colostomy or ileostomy and the patient finds himself with a huge bulging hernia with his colostomy or ileostomy right in the center of it. I have operated upon three such patients and wish to report the method I used in handling these cases. Report of a Case A 59-year-old robust man had a Miles operation in May, 1954. He promptly developed a hernia, which was repaired by the surgeon who had operated upon him. The hernia recurred and was again repaired by the same surgeon. It recurred again. The patient then went to another surgeon, who made two attempts at repairing the hernia without success and then referred the patient to me. On examination the patient was found to have a huge incisional hernia, principally to the left of the midline, with a colostomy opening near the center of it (fig.

Permanent colostomy is essential to success in the operative treatment of cancer of the rectum and rectosigmoid, no matter what type of operation is decided on for the individual case. It is also necessary in other conditions, notably obstruction from diverticulitis of the sigmoid and stricture of the rectum. Unfortunately, the laity and a large part of the medical profession have an exaggerated fear of colostomy. I have heard doctors in medical meetings say that they would rather die than have a colostomy. When such a statement has been made I have always felt that the person who made it knew very little about a properly constructed colostomy and much less about its proper care. As a matter of fact, a properly constructed, well placed and properly cared for colostomy causes the patient comparatively little inconvenience, and this statement is based on the opinions of a large number of patients

Carcinoma of the colon is a very common lesion, which occurs at all ages. In approximately 50 per cent of all cases encountered the disease has advanced beyond hope of surgical relief. There is an operative mortality varying from 5 to 35 per cent. Frequently the recovery of the patient is stormy, and in lesions of the rectum and lower part of the colon there is all too often the mutilation and social isolation associated with permanent colostomy. In growths more proximally situated, the problem of colostomy is avoided but the frequency of recurrence is greater. Metastasis to the liver and to regional lymphatic channels is always a specter which haunts the lives of those individuals fortunate enough to survive operation. The outlook for a patient proved to have even an operable carcinoma of the colon is, to say the most, not greatly encouraging. This statement is true despite the