File:Modern surgery, general and operative (1914) (14759154386).jpg

Identifier: modernsurgerygen1914daco (find matches)
Title: Modern surgery, general and operative
Year: 1914 (1910s)
Authors: Da Costa, J. Chalmers (John Chalmers), 1863-1933
Subjects: Surgery Surgery, Operative
Publisher: Philadelphia, London, W. B. Saunders company
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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ll. In a case of recurrent fibroid of the neck theyoimger Gross operated five times. Three years after Prof. Grosss death I 376 Tumors or Morbid Growths operated upon the same patient, and again two years later. Nine years afterthe last operation she was alive and well. In sarcoma of a long bone (thoughnot in giant-cell sarcoma) amputation should, as a rule, be performed. Blood-good proves that in some of these cases extensive excision is just as useful.In giant-cell sarcoma incision and curetting may be employed, or, if this isinsufj&cient, subperiosteal excision. Bloodgood has reported the cases of giant-cell sarcoma from Halsteds clinic. The reports show that excellent resultsfollow this plan of treatment. If the soft parts are involved, they must beremoved wide of the growth. Amputation is necessary only when the removalof soft parts must be so extensive as to hopelessly mutilate the limb. In sar-coma of either jaw-bone, excision; of the eye, enucleation; of the testicle, cas-
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Fig. 173.—Central sarcoma of the fibula. tration is demanded. Sarcoma of the ovary in adults demands removal, butin children the operation is generally useless. Sarcoma of the kidney in adultscalls for nephrectomy, but in children the operation is usually of little avail.In my experience, in the cases of sarcoma of the kidney which survived opera-tion the growth always appeared in the other kidney. In melanotic sarcomaextirpate the growth widely and remove anatomically related lymph-nodes, orin some cases amputate far away from the tumor and remove lymph-nodes.In very malignant sarcoma even amputation does not often cure. Removalof a sarcoma when there is no hope of a cure is often justifiable to prolong life,to relieve the patient of a foul, offensive, bleeding mass, and to permit of aneasier road to death by means of metastasis to an internal organ. In an in-operable case the ligation of the vessel of supply may do good. In sarcoma of Treatment of Sarcomata 377 the tonsil Dawbarn

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