File:Diseases of the rectum and anus- designed for students and practitioners of medicine (1910) (14804576223).jpg

Identifier: diseasesofrectum00gant (find matches)
Title: Diseases of the rectum and anus: designed for students and practitioners of medicine
Year: 1910 (1910s)
Authors: Gant, Samuel Goodwin, 1869?-
Subjects: Anus Diseases Rectal Diseases
Publisher: Philadelphia : F. A. Davis
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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s drawn downward as far aspossible and amputated, the proximal end being grasped with 1 Pigs. 175, 176, and 177 were used by Mr. Herbert W. Allingham in the chapterwritten by him on Cancer of the Rectum for the previous edition of this work. TREATMENT OF MALIGNANT TUMORS 553 forceps to prevent retraction. Spurting vessels are ligated, andoozing arrested by packing the wound with gauze compresseswrung out of hot water. If possible, the proximal end of thebowel is now brought down and united to the distal end by inter-rupted catgut or silk sutures passed through the entire thick-ness of the gut-wall. The author has also successfully employedHocheneggs method of denuding the mucosa of the anal seg-ment, pulhng the gut down through the latter, and suturing itto the skin about the anus. When feasible, either of thesemethods preserves the sphincter-muscle and thereby avertsincontinence. The ends of the divided sphincter-muscle are ap-proximated by means of buried catgut sutures, and a gauze
Text Appearing After Image:
Fig. 177.—Rectum Freed from its Surroundings. Ready to be Amputated. drain is inserted in the posterior wound, which is then closed bya continuous suture. Primary union is seldom obtained, owingto tension, and consequently more or less retraction follows. In most instances, especially when a large growth has beenremoved, it is impossible to bring the end of the rectum downto the anal segment. In such cases the bowel should be packedwith gauze and the entire wound left to heal by granulation.Dressings are now applied and held in place by a properly-adjusted T-bandage. The entire operation should not requiremore than twenty or thirty minutes. When the growth is sufficiently low down to involve thesphincter-muscle, the circular incision is made through the skin 554 DISEASES OF THE RECTUM AND ANUS at least half an inch (1.27 centimeters) to the outer side of theanal margin; the rectum is then isolated, the diseased portionamputated, and the end of the bowel drawn down and suturedto the

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