Revisiting Japanese contributions to abdomino-perineal resection for rectal cancer

Abdominoperineal resection (APR), commonly known as “Miles’ operation,” is a pivotal technique in rectal cancer surgery. While Miles was credited with formalizing the procedure in 1908, Japanese surgeons Ito and Torikata independently developed a similar approach in 1904, achieving comparable outcomes. Ito and Miles shared several concepts, and each described a critical anatomic challenge during surgery. Ito and Torikata introduced a two-team approach in 1906 that improved surgical safety and efficiency. This article explores Ito and Torikata’s contributions and their role in the global development of APR.