title: Audit and the birth of the abdomino-perineal excision for carcinoma of the rectum.
abstract: Sir Ernest Miles first performed his radical abdomino-perineal excision for carcinoma of the rectum in 1907. This event was the culmination of almost a decade of audit in which he carefully studied the outcomes of patients with rectal carcinoma. Miles's interpretation of his audit led, in a stepwise manner, to gradual changes in his operative technique and the eventual development of the radical abdomino-perineal operation; the operation that bears his name. The Miles operation and the principles upon which it is based, would lead to an improved outcome for patients with rectal carcinoma.
authors.affiliation: Department of Surgery, The University of Melbourne, Austin and Repatriation Medical Centre, Melbourne, Victoria, Australia. wiley@bigpond.net.au
authors.forename: Malcolm J
authors.initials: MJ
authors.lastname: Wiley
authors.forename: Nicholas
authors.initials: N
authors.lastname: Rieger
mesh_terms: D002277:Carcinoma / Q000266:history* / Q000601:surgery; D003107:Colorectal Surgery / Q000266:history*; D049672:History, 19th Century; D049673:History, 20th Century; D006801:Humans; D012004:Rectal Neoplasms / Q000266:history* / Q000601:surgery; D006113:United Kingdom