The practice of surgery . Fig. 78.—Gastrostomy—Witzels method (Keens SurgerjO- so far as it removes irritating food fi-om the immediate neighborhoodof the growth. The viscus to be opened is drawn up to the surface, and a ru])l:)er tubeor catheter is inserted, after the manner of Kader or Witzel. Theviscus is then attached to the abdominal wall, and the tube is left pro-truding. Through the tube food is introduced at will. After twoweeks the tube may be removed permanently. A fistulous tract is leftthrough which a tube may be reinserted and food poured in at any SARCOMA OF THE STOMACH 153 time.
The practice of surgery . Fig. 78.—Gastrostomy—Witzels method (Keens SurgerjO- so far as it removes irritating food fi-om the immediate neighborhoodof the growth. The viscus to be opened is drawn up to the surface, and a ru])l:)er tubeor catheter is inserted, after the manner of Kader or Witzel. Theviscus is then attached to the abdominal wall, and the tube is left pro-truding. Through the tube food is introduced at will. After twoweeks the tube may be removed permanently. A fistulous tract is leftthrough which a tube may be reinserted and food poured in at any SARCOMA OF THE STOMACH 153 time. The nature of the operation, if performed correctly, is such thata valve-like obstruction exists in the fistula, and the stomach-contentsare retained by the closed valve between feedings. By means of thisoperation a patients life may be prolonged many months. Besides cancer, the stomach is occasionally the seat of other tumors,both malignant and benign. Benign tumors make little trouble unless. Fig. 79.—Feeding by gastrostomy. they obstruct the pyloric outlet, and they need not concern us are rare. Of the other malignant tumors, the only one of im-portance is sarcoma of the stomach. SARCOMA OF THE STOMACH This disease has all the clinical characteristics of cancer of thestomach, and cannot with certainty be differentiated from it. Ana-tomically, it is found at the pylorus less frequently than is cancer—that is to say, about one-fourth of the sarcomata are pyloric. Generally,sarcoma involves the posterior wall and the greater curvature, arisingin the submucous coat. Whereas cancer is more common in men thanin women, sarcoma is equally common in both. It grows to a largesize often before killing the patient, and the tumor may be seen actuallydistending the abdominal wall. Hemorrhage is not common; pyloric 154 Till-: stenosis is not common; metastases are raic The disease is rai)i(l, andusually kills in iVom ten to eleven months. The onl}- treatment
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectsurgery, bookyear1910
