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abdominal portion abdominal wall anal anal fistulas anastomosis anus ascending colon bladder blood supply carcinoma catgut catheter cecum cent closed closure colectomy colic artery colonic stoma colostomy combined abdominoperineal resection cotton sutures diet dilatation dissection distal diverticulitis duodenum end-to-end anastomosis enema examination fascia finger fistula ileal stoma ileostomy ileotransversostomy ileum illustrated incision indicated inferior mesenteric inserted irrigation jejunum juice ligated lumen lymph lymphatic malignant lesion mesenteric artery middle colic middle colic artery mobilized mucosa nodes obstruction omentum one-stage combined abdominoperineal opening operation patient Payr clamp pelvic performed perineal peritoneal peritoneum placed Plate polyps portion of colon posterior postoperative preoperative procedure proctoscope prolapse rectal tube rectosigmoid rectum rectus muscle region removed resection right portion segment sigmoid skin small intestine sphincter splenic flexure stump superior hemorrhoidal superior mesenteric surgeon Surgery Surgical Treatment suture tablespoon technic tion tissue tract transection transverse colon ulcerative colitis urinary usually veins wound