Nephrectomy : its indications and contraindications / by Samuel W. Gross.

  • Gross, Samuel W. (Samuel Weissell), 1837-1889.
Date:
1885
Catalogue details

Licence: Public Domain Mark

Credit: Nephrectomy : its indications and contraindications / by Samuel W. Gross. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    of calculus, the patient having suffered from renal colic and haematuria ; while in that of Langenbuch, performed for supposed sarcoma, the kidney was converted into a sac, and was accidentally thrown away before its true nature could be determined. In two additional operations, done through the belly, Billroth and Sir Spencer Wells removed a sound kid- ney attached to a uterine growth. Both patients died. From a careful analysis of all the facts pertaining to the surgery of the kidney contained in this paper, based as it is upon a study of nearly four hundred and fifty cases of different operations, I believe that I am justi- fied in formulating the following propositions for discussion :— 1. That lumbar nephrectomy is a safer operation than abdominal nephrec- tomy. 2. That primary extirpation of the kidney is indicated, first, in sar- coma of adult subjects ; secondly, in benign neoplasms at any age ; thirdly, in the early stage of tubercular disease ; fourthly, in rupture of the ure- ter ; and, lastly, in ureteral fistula. 3. That nephrectomy should not be resorted to until after the failure of other measures, first, in subcutaneous laceration of the kidney; secondly, in protrusion of the kidney through a wound in the loin ; thirdly, in recent wounds of the kidney or of the ureter, inflicted in the performance of ova- riotomy, hysterectomy, or other operations; fourthly, in suppurative lesions; fifthly, in hydronephrosis and cysts ; sixthly, in calculus of an otherwise healthy kidney ; and, finally, in painful floating kidney. 4. That nephrectomy is absolutely contraindicated, first, in sarcoma of children; secondly, in carcinoma at any age, unless, perhaps, the disease can be diagnosticated and removed at an early stage ; and, thirdly, in the advanced period of tubercular disease.