Annals of surgery . omino-pelvic area whichseriously impair or destroy the continuity of the ureter. pathologic condition existing in the abdomino-pelvic areawhich so encroaches upon the ureter, whether by extension orpressure, that its function is seriously handicapped or de-stroyed. These three classes will be found to include the majorityof cases coming under observation. Pathologic conditionsassociated with calculi, fistulas, are largely of collateralimportance. The more commonly employed means for solvingthe difficulty have been implantation in bowel, bladder, orskin, and uret
Annals of surgery . omino-pelvic area whichseriously impair or destroy the continuity of the ureter. pathologic condition existing in the abdomino-pelvic areawhich so encroaches upon the ureter, whether by extension orpressure, that its function is seriously handicapped or de-stroyed. These three classes will be found to include the majorityof cases coming under observation. Pathologic conditionsassociated with calculi, fistulas, are largely of collateralimportance. The more commonly employed means for solvingthe difficulty have been implantation in bowel, bladder, orskin, and uretero-ureteral anastomosis. Nephrectomy of thecrippled side should, with justice, be definitely eliminated fromthe list of restitutional methods, for the impaired ureter isneither restored nor so transferred that its cloacal functionationmay continue; and in addition the kidney, which at this pointin the patients career has but a collateral significance, isablated. As well might one class an amputation following frac-. TRANS-URETERO-URETERAL-ANASTOMOSIS. 695 ture as a restitutional measure. Ligation of the proximal endof the ureter with induced hydronephrosis and subsequentcessation of nephric function (corroborated by the experi-mental work of James ^^) should also be excluded; for whilethe operative work is obviously less perilous than a primarynephrectomy, the end result is analogous—the patient isdeprived of the use of his kidney. But this analogy is not com-plete, for it is impossible to state the actual effect upon theorganism when a kidney is thus abruptly thrown out of func-tionation and an infection atrium may be found existent atany point between the kidney capsule and the ligature encir-cling the distal end of its ureter. That the remaining kidneymay be seriously crippled,—indeed, absent; that such condi-tions are all too frequently not ascertained previous to anabdominal operation; that it is most difficult to obtain exactinformation in the stress of so seriou
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Keywords: ., bookcentury1800, bookdecade1880, booksubjectsurgery, bookyear1885
