Surgical treatment; a practical treatise on the therapy of surgical diseases for the use of practitioners and students of surgery . excision of the tumor and establishment ofa new exit for the esophagus, either laterally in the axillary line of the chest,or the whole proximal esophagus may be brought out of the mediastinumand implanted under the skin down the front of the thorax. This latteroperation may be divided into two operations. This program means atranspleural operation. The esophagus is reached by subperiosteal resec-tion of the sixth to the twelfth ribs. By connecting the esophagus,
Surgical treatment; a practical treatise on the therapy of surgical diseases for the use of practitioners and students of surgery . excision of the tumor and establishment ofa new exit for the esophagus, either laterally in the axillary line of the chest,or the whole proximal esophagus may be brought out of the mediastinumand implanted under the skin down the front of the thorax. This latteroperation may be divided into two operations. This program means atranspleural operation. The esophagus is reached by subperiosteal resec-tion of the sixth to the twelfth ribs. By connecting the esophagus, whichis stitched to the skin, with the gastrostomy fistula, by a long tube, thepatient may drink fluids (Fig. 1431). Ach, of Munich, performed a one-stage operation as follows: Througha left oblique abdominal incision the cardia is examined. The esophagusis then exposed in the left side of the neck (see Cervical Esophagotomy,page 442), isolated, a tape passed around it, and the wound tumor is next exposed through the abdomen and isolated from itssurrounding connections. The best exposure is secured by continuing. Fig. 1431.—Resection of Cardiac End of Stomach for possibilities of connecting stump of esophagus and stomach by means of an ex-ternal rubber tube as practised by J. H. Zaaijer of Leiden. an incision from the epigastrium opposite the eighth left cartilage, downwardand outward to the tip of the eleventh rib, thence upward and backward to theeighth interspace in the midaxillary line. The eighth, ninth and tenth ribsare divided in the axillary line, and the costal cartilage of the seventh nearthe sternum. The flap is retracted upward, the esophagus clamped anddivided. The ligated esophagus is then dissected free in the posteriormediastinum, brought out through the neck wound, the esophageal openingin the diaphragm closed, and the esophagus implanted under the skin at theleft of the sternum. The resection of the stomach is then completed at a
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Keywords: ., bookcentury1900, bookdecade1920, booksubjectsurgery, bookyear1920
