. Diseases of the rectum and anus: designed for students and practitioners of medicine. onsid-ered inoperable, he could thus extirpate growths located abovethe peritoneal attachments of the rectum. In order to gain still more room and permit the operatorto reach and excise or resect growths situated in the upperpart of the rectum and lower sigmoid, Bardenheuer. in 1880,proposed the removal of a portion of the sacrum. Kraske,however, in a contribution to the Berlin Congress of Surgery,in 1885, was the first surgeon to describe in detail the sacral TREATMENT OF MALIGNANT TUMORS 545 Operation for
. Diseases of the rectum and anus: designed for students and practitioners of medicine. onsid-ered inoperable, he could thus extirpate growths located abovethe peritoneal attachments of the rectum. In order to gain still more room and permit the operatorto reach and excise or resect growths situated in the upperpart of the rectum and lower sigmoid, Bardenheuer. in 1880,proposed the removal of a portion of the sacrum. Kraske,however, in a contribution to the Berlin Congress of Surgery,in 1885, was the first surgeon to describe in detail the sacral TREATMENT OF MALIGNANT TUMORS 545 Operation for excision of the rectum. He reported two casesin which he had successfully employed this method. Briefly described, the original Kraske operation (sacral ex-cision) is performed as follows:— The patient is anesthetized and placed on the rightside. Beginning at the center of the sacrum, a median in-cision is made through the soft parts downward to the fibrous, muscular, and ligamentous structures are then cutaway from the left side of the sacrum and coccyx, below the \^ /^. Fig. 174.—Showing Amount of Bone Removed by Different Operations in Proc-tectomy. A-G, Kraske; A-B, Hochenegg; A-D, Rydygier, Bardenheuer,Levy, and Kraske In Extreme Cases. The Red Lines Show the Skin In-cisions of Rhen and Rydygier. level of the upper margin of the third sacral vertebra. Thecoccyx is then removed, and with a gouge or chisel the lowerpart of the left half of the sacrum is cut away to a curved line,beginning at a point on the left side of the bone, opposite thelower margin of the third sacral foramen, the detached portionof bone including the fourth sacral foramen (Fig. 174). Therectum is now freed from its posterior attachments. The pa-tient is then changed to the lithotomy posture, with the hips well elevated, and the anterior attachments of the rectum care-ss 546 DISEASES OF THE RECTUM AND ANUS fully severed. The peritoneal cavity having been protectedfrom infection, the extent
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectanusdis, bookyear1910
