The Practitioner . quentoperation for its cure, the method is found to have a highermortality than enterectomy. From a very elaborate paper byC. L. Gibson in the Annals of Surgery, 1900, II., p. 676, wefind the mortality in 354 operations for gangrenous hernia tobe as follows :—Primary enterectomy, 26 per cent. ; resectionwith artificial anus of ends of intestine, 50 per cent. ; artificialanus alone, 53 per cent. He also quotes Zeidlers statisticsrecorded ten years earher, giving a mortality of 50 per cent,for resection, and 74 per cent, for artificial anus. So that,making all due allowance fo
The Practitioner . quentoperation for its cure, the method is found to have a highermortality than enterectomy. From a very elaborate paper byC. L. Gibson in the Annals of Surgery, 1900, II., p. 676, wefind the mortality in 354 operations for gangrenous hernia tobe as follows :—Primary enterectomy, 26 per cent. ; resectionwith artificial anus of ends of intestine, 50 per cent. ; artificialanus alone, 53 per cent. He also quotes Zeidlers statisticsrecorded ten years earher, giving a mortality of 50 per cent,for resection, and 74 per cent, for artificial anus. So that,making all due allowance for the vagaries of statistics, theadvantage lies with immediate enterectomy. Therefore, shouldthe practitioner meet with a case of distinctly gangrenoushernia, he may feel assured that his patient will have the bestchance if the gangrenous gut can be removed and the intestinesutured and returned. As to the method to be employed for resection there is littleto choose between simple suture and the use of a button or. Fig. g. Authors twin-clamp forceps for Enterectomy. bobbin—the mortality is found to be about equal with in the British Isles the tendency of most surgeons is toemploy simple suture, and to obtain better results thereby, inAmerica the Murphy button is still largely employed, and bymany preferred to suture. Personally, I prefer simple sutiue as INTESTINAL OBSTRUCTION. 185 a rule ; and in order to render this a more simple measure,particularly when skilled assistance is wanting, I have intro-duced some special intestinal anastomosis forceps (Fig. 9),and have myself employed them recently for two cases ofgangrenous femoral hernia, as in Fig. 10.
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