The pathology and surgical treatment of tumors . sion of the cervix uteri for carcinoma was madeby Osiander. The operation was later perfected by C. J. M. Langen-beck and by Schroeder. This operation should be restricted to cases of carcinoma beginning upon thevaginal portion of the cervix and inwhich the disease has not extendedto the body of the uterus. Surgeonsare not agreed as to the value of thisoperation in the treatment of uterinecarcinoma. The combined statisticsrepresenting cases from the practiceof a number of able surgeons showa mortality of about per of the ardent ad
The pathology and surgical treatment of tumors . sion of the cervix uteri for carcinoma was madeby Osiander. The operation was later perfected by C. J. M. Langen-beck and by Schroeder. This operation should be restricted to cases of carcinoma beginning upon thevaginal portion of the cervix and inwhich the disease has not extendedto the body of the uterus. Surgeonsare not agreed as to the value of thisoperation in the treatment of uterinecarcinoma. The combined statisticsrepresenting cases from the practiceof a number of able surgeons showa mortality of about per of the ardent advocates of thisoperation claim that in nearly half ofthe cases the carcinoma did not returnafter operation. Such a statement,however, must be accepted with a gooddeal of allowance. On the contrary,the champions of hysterectomy under-rate the value of this operation. Com-mon sense would dictate that in alimited carcinoma of the external os it is no more necessary to removethe entire uterus than it would be to extirpate the whole of the lower lip. Fig. 245.—Schroeders supravaginal ampu-tation of the cervix for carcinoma, showing theextent of the excision and the ligature of thelower branch of the uterine artery (after Pozzi). CARCINOMA. 361 in a beginning carcinoma of the lip. Here as elsewhere the surgeonmust show good sense and judgment in selecting the cases for partialand those for complete removal of the uterus for carcinoma. Schroedersoperation is the one that promises the best results in well-selected uterus is drawn down to the vulva by vulsellum forceps, anda strong loop of thread is passed through and above each of the lateralculs-de-sac (Fig. 245). These loops serve to draw the parts down andto compress the uterine artery. The cervix is then isolated, througha circular incision made at the vaginal insertion, as far as the internal vessels are at once tied. The dissection is made as far aspossible by the use of blunt instruments, to guard against
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Keywords: ., bookcentury1800, bookdecade1890, booksubjectneoplas, bookyear1895
