Surgical treatment; a practical treatise on the therapy of surgical diseases for the use of practitioners and students of surgery . uture. A 756 SURGICAL TREATMENT second mattress suture is placed about 2 cm. (% inch) from the distal side,holding the intestine to the stomach. of this is to prevent theintestine from kinking at the anastomosis. It is possible in some casesto connect the duodenum directly with the stomach pouch. This can notoften be done in operations for cancer, but it can commonly be practised inresections for ulcer. Mayo prefers closing the duodenal stump and doing
Surgical treatment; a practical treatise on the therapy of surgical diseases for the use of practitioners and students of surgery . uture. A 756 SURGICAL TREATMENT second mattress suture is placed about 2 cm. (% inch) from the distal side,holding the intestine to the stomach. of this is to prevent theintestine from kinking at the anastomosis. It is possible in some casesto connect the duodenum directly with the stomach pouch. This can notoften be done in operations for cancer, but it can commonly be practised inresections for ulcer. Mayo prefers closing the duodenal stump and doing anindependent gastroenterostomy. The radical operation for cancer of the pyloric end of the stomachshould begin with removal of the groups of lymphatics adjacent to the dis-ease, and the ligation of the four vessels. W. J. Mayo proceeded in somecases after the method of E. Polya (Surg., Gyn. & Obst., xix, 1914). Thediseased segment of the stomach is removed as above described. Thestump of the duodenum is closed. An opening is then made in the transversemesocolon and the upper part of the jejunum drawn through the Fig. 1429.—Resection of Cardiac End of Stomach for lines of incision and upward displacement of diaphragm. The stump of the stomach which is held in a crushing clamp and the rawedges of which have been cauterized is placed at the side of the loop andunited by the serosa-to-serosa suture of fine silk as is done for gastroenter-ostomy (Fig. 1428). Jf the opening in the stomach is larger than is needed,it can be reduced as the suture is applied. Rubber-guarded holding clamps are then applied to the stomach andintestine, the crushing clamp is removed, the jejunum incised, and thethrough-and-through suture of chromicized catgut is applied around thewhole circumference of the opening. The outer serosa suture is then com-pleted. The anastomosis is then drawn through the opening in the trans-verse mesentery and the margin of the opening fastened to t
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Keywords: ., bookcentury1900, bookdecade1920, booksubjectsurgery, bookyear1920
