A Reference handbook of the medical sciences embracing the entire range of scientific and practical medicine and allied science . nvolved field than in this clinical observation is due to the lesservirulence and slower progress of epithelioma, or to thefact that as a rule epithelioma is usually, because of thenature of its growth, discovered sooner than adeno-car-ciuoma, I do not know. But it is my belief that ejiithe-lioma of the cervix is far less malignant than adeno-carcinoma. However, the rule in operating is to keej) asfar away from the cervix as possible There a
A Reference handbook of the medical sciences embracing the entire range of scientific and practical medicine and allied science . nvolved field than in this clinical observation is due to the lesservirulence and slower progress of epithelioma, or to thefact that as a rule epithelioma is usually, because of thenature of its growth, discovered sooner than adeno-car-ciuoma, I do not know. But it is my belief that ejiithe-lioma of the cervix is far less malignant than adeno-carcinoma. However, the rule in operating is to keej) asfar away from the cervix as possible There are tworoutes for operating upon cancer of the cervix the vag-inal and the abdominal. And of all of cancer ofthe uterus which come to us for treatment, scarcely tenper cent, can be subjected to any radical operation. ((() Indications for the Radical Var/inal Operation.—These are to be found iix the immediate mortality and iuthe ultimate results. The death rate from vaginal hysterectomy in cancer ofthe cervix should not be more than five per cent. It is 89 REFERENCE HANDBOOK OF THE MEDICAL most difficult to determine precisely the ultimate resultsbecause so many patients are Inst sight of, and the groupsof cases fallinginto the hands of (irtTcrent operators varyso much in the extent of the involvement. Of all cases operated uponby the vaginalroute, about six-ty per cent, re-cur within thelirst year afterI iperatiou. 0 fthe remainder,not more thantwenty percent,arc free fr(5m re-currence afterfive years. Andthese results arefound by thosewho aie thor-ough masters oftechni(|ue. Vaginal hys-terectom_v forcancer of thecervix is an op-eration whichcan be rapidlyperformed anddoes not necessi-tate a profounddegree of narco-sis. It is there-fore indicated inthose who areaged and whowould not foro t h e r reasonsstand a more se-vere and pro-longed operation. If it is indicated at all, it is in oldwomen, in very stout women, and in those with nephritisor
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