The pathology and surgical treatment of tumors . in small sections withfine silk. The bowel sections are made somewhat obliquely at theexpense of the convex side, and the ends are at once united with adouble row of sutures. The mesentery corresponding with the sectionof bowel removed should not be excised, but be folded upon itself, andthe ligatured margin should be sutured as shown in Figure 217. Ifthe lumina of the bowel-ends do not correspond in size, the smaller endis cut more obliquely. If the difference in size is too great to be equal-ized by this method, as after excision of the cecum,
The pathology and surgical treatment of tumors . in small sections withfine silk. The bowel sections are made somewhat obliquely at theexpense of the convex side, and the ends are at once united with adouble row of sutures. The mesentery corresponding with the sectionof bowel removed should not be excised, but be folded upon itself, andthe ligatured margin should be sutured as shown in Figure 217. Ifthe lumina of the bowel-ends do not correspond in size, the smaller endis cut more obliquely. If the difference in size is too great to be equal-ized by this method, as after excision of the cecum, both ends areclosed, and the continuity of the bowel is restored by lateral anasto-mosis, by suturing, or with the aid of perforated decalcified use of decalcified perforated bone-plates to restore the continuityof the bowel has been resorted to by the writer in three cases of resec- CARCINOMA. 335 tion of the cecum for carcinoma, and in every instance this methodof approximation proved eminently successful (Fig. 218). c f^ -1. Fig. 218.—Restoration of the continuity of the bowel after resection of the cecum for carcinoma, with theaid of perforated decalcified bone-plates. Intestinal Anastomosis.—If the carcinoma, by the promotion of car-cinomatous adhesions with neighboring organs or by extensive regionalinfection through the lymphatic channels, has advanced beyond thelimits of a radical operation, an intestinal anastomosis should be operation consists in establishing a fistula between the bowelabove and below the tumor. A R The operation can be doneby making in the respectiveparts of the bowel an incis-ion four inches in length,as advised by Abbe, andthe union is effected by adouble row of silk single row of suturesmight prove all-sufficient,but as a matter of safety adouble row is same object can beaccomplished in a shortertime and with a greater de-gree of security by substi-tuting for the inner row of sutures perforat
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Keywords: ., bookcentury1800, bookdecade1890, booksubjectneoplas, bookyear1895
