Surgical treatment; a practical treatise on the therapy of surgical diseases for the use of practitioners and students of surgery . from thirty-six hours to four or more days, the segment bearing the tumor 588 5 URGICA L TREA TMEN T is resected. Or the resection may be done at once after the bowel has beensewed to the wound edges. In the small intestine the upper end may be cutoff 5 to cm. (2 to 3 inches) from the skin; and the two ends united by anasto-mosis suture or connected by a large tube. If the tumor is low down, atube may be placed in each opening separately (Fig. 1237). As
Surgical treatment; a practical treatise on the therapy of surgical diseases for the use of practitioners and students of surgery . from thirty-six hours to four or more days, the segment bearing the tumor 588 5 URGICA L TREA TMEN T is resected. Or the resection may be done at once after the bowel has beensewed to the wound edges. In the small intestine the upper end may be cutoff 5 to cm. (2 to 3 inches) from the skin; and the two ends united by anasto-mosis suture or connected by a large tube. If the tumor is low down, atube may be placed in each opening separately (Fig. 1237). As a means of treating the distended loop of bowel above the tumor theglass tube is most useful. It permits keeping the parts clean while the pa-tient is recovering from the obstruction (Fig. 1238). Carcinoma of the intestine, if removable, may, of course, be treated byone complete operation; resection, enteroanastomosis and closure of thewound. In many cases this treatment may be employed. They are thecases in which the disease is discovered early before acute obstruction hasdeveloped, and the resistance of the patient is Fig. 1236.—Closure of Artificial Anus. The pressure of the clamp has caused necrosis of the spur between the two loops and a wide communication is established. In some of these cases the method of entero-enterostomy with theelastic ligature may be employed. The loop with the growth is broughtout through the wound and a lateral short-circuiting anastomosis madewith the elastic ligature (page 675) about cm. (3 inches) from thetumor. The anastomosis is returned to the abdomen. The bowel is thenclamped for resection of the tumor. A purse-string suture is placed aroundeach arm of the bowel between the growth and the anastomosis. Thedistal limb is divided, its end closed and dropped back into the 11 tumor is then removed by amputating through the proximal limb anda glass tube is fixed in the bowel. When the elastic ligature cuts through,the disc
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Keywords: ., bookcentury1900, bookdecade1920, booksubjectsurgery, bookyear1920
