Surgical treatment; a practical treatise on the therapy of surgical diseases for the use of practitioners and students of surgery . d extent of bowel and mesocolon to be 11—38 594 SURGICAL TREATMENT necessarily mean cancer. Masses of enlarged glands may sometimes beremoved and found entirely free from cancer. If the cancer is adherent posteriorly it may be necessary to remove theureter or the kidney also. Extension of the growth to the abdominal wallcalls for resection of as much of the latter as is necessary. In some cases one or more loops of small intestine may
Surgical treatment; a practical treatise on the therapy of surgical diseases for the use of practitioners and students of surgery . d extent of bowel and mesocolon to be 11—38 594 SURGICAL TREATMENT necessarily mean cancer. Masses of enlarged glands may sometimes beremoved and found entirely free from cancer. If the cancer is adherent posteriorly it may be necessary to remove theureter or the kidney also. Extension of the growth to the abdominal wallcalls for resection of as much of the latter as is necessary. In some cases one or more loops of small intestine may be adherent andinvolved in the growth. There resection and end-to-end or lateral anasto-mosis is not difficult; the same of involvement of the ovaries, tubes or uterus. The growth will sometimes be found attached to the bladder. Resectionof this viscus should be done without hesitation. The organ may be suturedand a good result hoped for. Operation in one stage, with resection of the cancer and anastomosis ofthe bowel, is rarely justifiable in cases which have even moderate obstruction. LIGATURE OrINfERIORMESENTERIC /ARTERY. Fig. 1244.—Cancer of Sigmoid and extent of bowel and mesocolon to be removed. The vitality of the bowel is damaged, and sutures may not hold. This isthe condition in the majority of cases; and the surgeon should not be temptedto do a completed operation. It is much wiser to do cecostomy if the ob-struction is urgent. If the obstruction is not a pressing factor, the operationin which the diseased loop is fastened outside of the body, and later resected,is by all means the safest operation. This operation is especially applicableto the second half of the colon. Colostomy just above the disease, whichmay be resected with the tumor at a later operation, is to be considered forsome cases. If the surgeon plans a wide resection with removal of mesocolon andvessels, an end-to-end anastomosis may be made or the bowel ends may besewed in the abdomi
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Keywords: ., bookcentury1900, bookdecade1920, booksubjectsurgery, bookyear1920
