The pathology and surgical treatment of tumors . obstruction, substantial measures. have become, forreasons, obsoleteIf the carcinoma produces obstruction, an arti-ficial anus will benefit thepatient in two ways : it willexclude from the fecal circula-tion the diseased part of therectum, and at the same timewill establish a free outlet forthe intestinal contents. If anartificial anus is made undersuch circumstances, it shouldbe made with a view of com-pletely interrupting the fecalcirculation and thus affordingabsolute rest for the excludedpart of the bowel. Maydls colostomy (Fig. 221) will an
The pathology and surgical treatment of tumors . obstruction, substantial measures. have become, forreasons, obsoleteIf the carcinoma produces obstruction, an arti-ficial anus will benefit thepatient in two ways : it willexclude from the fecal circula-tion the diseased part of therectum, and at the same timewill establish a free outlet forthe intestinal contents. If anartificial anus is made undersuch circumstances, it shouldbe made with a view of com-pletely interrupting the fecalcirculation and thus affordingabsolute rest for the excludedpart of the bowel. Maydls colostomy (Fig. 221) will answer theserequirements to perfection. An incision ff)ur inches in length is madeabout two inches above Pouparts ligament, halfway between the .symphy- FiG. 221.—Maydls inguinal colostomy. CARCINOMA. 339 sis pubis and the anterior superior spinous process of the ilium, parallelwith the fibres of the external oblique muscle. The muscular layers areseparated as far as possible by the use of blunt instruments. The trans-versalis fascia and the peritoneum are incised to th^ extent of the externalwound. Some care is now necessary to recognize, seize, and bring for-ward into the wound in proper position the sigmoid flexure. As soonas the proper loop has been found the mesentery near the bowel is tun-nelled with a hemostatic forceps, and a glass tube fourinches in length, the size of an ordinary lead pencil,covered by several layers of gauze, is drawn throughthis opening with the forceps. The glass tube servesas a bridge for the prolapsed loop of the two limbs of the bowel are now sutured together ° Fig. 222.—Maydls co- on each side by two sero-muscular sutures under- lostomy, showing the posi-neath the bridge (Fig. 222). Next, the prolapsed ^^ZZV^loop is sut
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Keywords: ., bookcentury1800, bookdecade1890, booksubjectneoplas, bookyear1895
