Kolpohysterectomy for cancer : with tables comparing its methods and results / by Sara E. Post.

  • Post, Sara E.
Date:
[1886?]
Catalogue details

Licence: Public Domain Mark

Credit: Kolpohysterectomy for cancer : with tables comparing its methods and results / by Sara E. Post. Source: Wellcome Collection.

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    Opinions Regarding the Operation.— In Germany, in 1882, Rokitansky’s was almost the only dissenting voice. At the present time the operation of kolpohysterectomy for cancer has been, within limits, accepted as a legitimate procedure. In France, Pollaillon, in 1882, considered extirpation of the uterus an ill-advised operation, quoting West’s statistics and the statistics of Freund’s operation. In 1885, Pollaillon still prefers amputation, stating that in cancer of the cervix the disease does not early spread to the body, while in cancer of the body the diagnosis is uncertain. Despres and Championniere think that permanent cure of cancer of the uterus is impossible, that where the patient has remained well after I the operation an error in diagnosis was made. Demons, on the contrary, in 1883, said that total extirpation of the uterus by the vagina merited a better reception than had been accorded I to it in France. It was practised upon subjects already condemned to a fatal issue, with the probability of a more or less prolonged accession of health, and with the possibility of a permanent cure. Demons states that the most usual time for the return is four or five months after the operation, with death at the end of twelve or fourteen months. Return may be in the cicatrix, but more often it is in the pelvic cellular tissue. I He goes on to say that women suffer much less from the return than from the primitive growth, that hemorrhage is less frequent and less grave.1 Desoubroux, in speaking of extirpation of the kidney for cancer, says: “ We must admit tha| there is a great probability of a return, yet we 1 would operate, because, not to do so, is condemnation to certain death, while in favor of the operation is the fact that for some time after it the patient is comparatively free from the disease.” Terrier places extirpation of the uterus for cancer upon the same plane as extirpation of the kidney for malignant disease. Without being assured against its return, he would operate, because ablation is the only possible curative procedure. Sebileau remarks: “ The operation should be performed because, without it, the patient is doomed to certain death and to a disgusting infirmity; while, if there be a return after the operation, there is less danger of accidents and a diminution of pain.” In England, Duncan favors the operation for carcinoma or sarcoma of the body and cervix. Doran is opposed to the operation on the ground that the disposition of the lymphatics of the uterus is such as to make a radical extirpation of the disease impossible. Playfair thinks the ope¬ ration of doubtful benefit, as the diagnosis of cancer is necessarily too late for complete removal. Purcell remarks that wTe should exjiect no more from extirpation of the uterus than from extirpation of the tongue r 1 Rev. rle Chir., 1881, iv. 633.