File:Modern surgery, general and operative (1919) (14597306608).jpg

Identifier: modernsurgerygen1919daco (find matches)
Title: Modern surgery, general and operative
Year: 1919 (1910s)
Authors: Da Costa, J. Chalmers (John Chalmers), 1863-1933
Subjects: Surgery, Operative
Publisher: Philadelphia : Saunders
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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five times. Three years after Prof. Grosss death I operatedupon the same patient, and again two years later. Nine years after the last Treatment of Sarcomata 429 operation she was alive and well. In sarcoma of a long bone (though not ingiant-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 isinsufhcicnt, subperiosteal excision. Curetting is admissible only when there isa definite shell of bone beyond the tumor. Bloodgood has reported the cases ofgiant-cell sarcoma from Halsteds clinic. The reports show that excellentresults follow this plan of treatment. If the soft parts are involved, they mustbe removed wide of the growth. Amputation is necessary only when the re-moval of soft parts must be so extensive as hopelessly to mutilate the limb.In sarcoma of either jaw-bone, excise; of the eye, enucleate; of the testicle, cas-
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FiG. 202.—Central sarcoma of the fibula. trate. Sarcoma of the ovary in adults demands removal, but in children theoperation is generally useless. Sarcoma of the kidney in adults calls for neph-rectomy, but in children the operation is usually of little avail. ^ In my experi-ence, in the cases of sarcoma of the kidney which survived operation the growthalways appeared in the other kidney. In melanotic sarcoma extirpate thegrowth widely and remove anatomically related lymph-nodes, or in somecases amputate far away from the tumor and remove lymph-nodes. Theprobability of recurrence is very strong. In very malignant sarcoma evenamputation does not often cure. Removal of a sarcoma when there is no hopeof a cure is often justifiable to prolong life, to relieve the patient of a foul,ofifensive, bleeding mass, and to permit of an easier road to death by means ofmetastasis to an internal organ. In an inoperable case the Hgation of the vessel■of supply may do good. In sarcoma of the tonsil

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