Cancer Of The Stomach | by A. W. Mayo Robson
It would seem hardly necessary to find any excuse for the publication of a monograph on cancer of the stomach and its treatment, for when it is realised how frequent gastric cancer is and that the disease is at first local and curable in a considerable proportion of cases by early removal; the stomach being in fact invaded more frequently than any other organ accessible to direct observation, it is curious that surgical treatment of this disease has not yet received more attention.
| Title | Cancer Of The Stomach |
| Author | A. W. Mayo Robson, D.Sc, F.R.C.S. |
| Publisher | William Wood And Company |
| Year | 1907 |
| Copyright | 1907, William Wood And Company |
| Amazon | Cancer of the Stomach |
By A. W. Mayo Robson, D.Sc, F.R.C.S., Member Of Council Royal College Of Surgeons ; Vice-President Royal College Op Surgeons, 1902-3 And 1904-5; Hunterian Professor Of Surgery And Pathology, 1897, 1900 And 1904; Bradshaw Lecturer, 1905; Hon. Surgeon Dreadnought Hospital And Lecturer London School Of Clinical Medicine, 1906; Consulting Surgeon To The General Infirmary At Leeds, And To The Keighley And Batley Hospitals ; Hon. Fellow American Surgical Society; Hon. Member French Surgical Society ; Emeritus Professor Of Surgery In The Leeds University; Hon. President International Medical Congress, Paris, 1900, And Lisbon, 1906; President D'honneur International Congress Of Surgery, 1905
Preface- IN responding to the Editor's request to write a small work on Cancer of the Stomach for the Nisbet Modern Clinics Series, I have tried to carry out his wish to make it practical and useful. In doing ...
- Chapter I. Introduction With Some General Remarks On Cancer
- It would seem hardly necessary to find any excuse for the publication of a monograph on cancer of the stomach and its treatment, for when it is realised how frequent gastric cancer is and that the dis...
- Introduction With Some General Remarks On Cancer. Continued
- One exciting cause only Ave are certain of, and that is irritation in a A7ariety of forms. Another fact Ave can absolutely proATe is that cancer is at first a local disease, and only later a constitut...
- Chapter II. Surgical Anatomy Of The Stomach
- Although it is unnecessary to give a complete anatomical description of the stomach, yet some consideration of its surgical anatomy is called for in dealing with any branch of gastric surgery. Under p...
- The Stomach Chamber
- The stomach chamber is a well-defined space in the upper abdomen occupied by the stomach. It has a sloping floor which is known as the stomach bed, composed of the front of the left kidney, the left s...
- Chapter III. General Diagnosis Of Stomach Diseases, Including Cancer
- The time lias passed in which the surgeon may rest content to act on a diagnosis already made for him, leaving with his medical confreres the onus in case of error; for he cannot shirk the responsibil...
- Abdominal Regions
- I have found the method of artificially dividing the abdomen into four regions by two lines passing from the ninth costal cartilage to the opposite anterior superior spine to simplify for clinical pur...
- Instrumental Aids To Diagnosis
- In case of pending starvation from obstruction at the cardiac orifice, whether on the oesophageal or stomach side of the sphincter, the question of gastrostomy will arise ; but it must first be made c...
- Skiagraphy
- The use of Rontgen rays has a distinct role in certain stomach cases, especially in the diagnosis of the presence or absence of metallic bodies in the oesophagus or stomach. While the Murphy button wa...
- Fluorescent Media For Transillumination Of The Stomach
- In a paper on dilatation of the stomach and gastroptosis, R. C. Kemp (2), holding that transillumination of the stomach is the ideal method of ascertaining its limits, advocates the introduction of fl...
- Chemical Reactions
- In reference to the diagnosis of malignant disease of the stomach the relative abundance or absence of free HCl has been pointed out by Ewald as being of importance. In order to determine its existenc...
- Examination Of Vomited Matters
- With regard to vomit, the first thing to consider is the quantity vomited at one time. Nurses should be trained to estimate this carefully and also to preserve specimens on all occasions. In dilated s...
- Examination Of The Blood
- The blood, as a rule, shows the changes found in secondary anaemia. Beyond this the information given by an examination is of doubtful value. Krokiewicz states that there is no change in the red bl...
- Chapter IV. Cancer Of The Stomach
- Primary cancer oŁ the stomach may be of the cylindrical or spheroidal, very rarely of the squamous type (Rolleston, Journ. Pathology and Bacteriology, August, 1905). If the stroma be abundant the t...
- Extension Through The Lymphatics
- To Cuneo in his masterly thesis the profession is indebted for the excellent description of the lymphatic system of the stomach, which is well shown in the diagram taken from his work (p. 19). The lym...
- Extension By Continuity
- Cancer always extends beyond the area of induration, for while the limit of induration may be the diseased mucosa, the sub-mucosa may be involved in growth for some distance beyond, and only scattered...
- Extension Through Adhesions
- In a very large proportion of cases adhesions are found at the time of operation between a cancerous tumour of the stomach and adjoining organs, especially the pancreas, liver and biliary passages. Th...
- Pre-Cancerous Conditions
- The so-called pre-can-cerous stage of malignant disease may be due to disturbances of nutrition, to previous injury, to congenital defect, or to other departures from the normal conditions. Senility a...
- Ulcus Carcinomatosum
- The question of the cancerous transformation of an ulcer of the stomach was first discussed by Cruveilhier in 1839. Rokitansky, in 1840, also recognised the difference between chronic ulcer and cancer...
- Ulcus Carcinomatosum. Part 2
- Dr. Newton Pitt (4) drew attention to seventeen obscure gastric cancer cases that had occurred in Guy's Hospital, in which the main symptoms had been unconnected with the stomach. They are classified ...
- Ulcus Carcinomatosum. Part 3
- We should be able to make our diagnosis (if needful by an exploratory operation) before a tumour can be felt, if we want to obtain the best results from the surgical treatment of gastric carcinoma. ...
- Ulceration
- If the subject of gastric carcinoma survives for a sufficient length of time the disease will break down leading to ulcer, but the patient may die before ulceration occurs. Osier and McRae found ulcer...
- The Character Of The Vomit Or Of The Stomach Contents
- If the patient is sick, the vomited matter can be examined, but in the absence of sickness, lavage of the stomach should be performed an hour after an EwalcFs test meal. Before coming to a definite de...
- Digestive Properties Of Stomach Contents
- This may be proved by testing the digestive power on albuminous foods of the fluid removed after a test meal, or by Schwarz's method of examining by the Rontgen rays after the patient has swallowed a ...
- Microscopic Examination
- The presence of new growth in the vomit or in the fluid removed by lavage is, of course, of prime importance, but it can only rarely be found, and it is quite unjustifiable to attempt to obtain it by ...
- Microscopic Examination. Part 2
- Let us remember also that to prolong the investigation uselessly and to wait until a tumour develops is to lose the favourable time for a radical operation ; and although a clinical examination of the...
- Microscopic Examination. Part 3
- To pass to the genuine cancer cases, what can we do for them when diagnosed at an early stage ? This will depend : (1) on the position of the growth; (2) on its extent; (3) on the presence of adhesion...
- Microscopic Examination. Part 4
- Case 1 Mr. B-, aged sixty-two years. Symptoms for a year. Epigastric tumour noticed a month. No free HCl in vomit. Exploratory operation November 15th, 1900. Ring of cancer found, forming hourglass...
- Microscopic Examination. Part 5
- Mr. A-, middle-aged, who had been ailing for a year, and had. had stomach symptoms for three months and a noticeable tumour for six weeks, was supposed to be too ill and anaemic for operation, but as ...
- Microscopic Examination. Part 6
- Tea.-Bread and butter or a little toast, one cup of tea. 8 p.m.-Cup of milk and one tea-spoonful of plasmon. Supper.-Nearly one pint of boiled milk and bread. In 1906, over five years after o...
- Chapter V. Simple Tumours Of The Stomach That May Be Mistaken For Cancer
- Benign tumours of the stomach are rare, and unless they invade the orifices may produce no symptoms, though when ulcerating they may simulate malignant disease. Tumours Of The Stomach Caused By Chr...
- Plastic Linitis
- The term plastic linitis has been used somewhat indefinitely to indicate a chronic induration and thickening of the walls of the stomach with a marked diminution of the gastric cavity. It is an e...
- Adenoma
- Simple glandular tumours of the stomach may be single or multiple, and they are specially liable to form polyps They may be found in any part of the stomach, but are nut infrequently found to occur at...
- Lymphadenoma
- This is a rare form of tumour characterised by the appearance of multiple polypoid projections into the cavity of the stomach. Pitt (2) stated that he had only been able to find seventeen cases rec...
- Myoma
- Tumours resembling uterine myomata histologically may spring from the muscular coat of the stomach and push the mucous membrane before them, projecting into the stomach as sessile or polypoid tumours,...
- Lipoma
- Lipomata in the stomach wall are extremely rare; they may arise from the submucous tissue and project into the cavity of the stomach, or from the subserous coat and project into the peritoneal cavity....
- Cysts
- Small cysts from obstruction of gland ducts are not uncommon. Ruysch (7) described a gastric dermoid cyst containing hair. Engel Reimers described a multilocular lymphangioma of the stomach wall occur...
- Chapter VI. Sarcoma Of The Stomach
- Primary gastric sarcoma is not so rare as it. is generally thought to be. It is probable that a num-ber of cases described as cancer have been truly sarcoma; this we may conclude from the fact that a ...
- Chapter VII. Dilatation Of The Stomach
- Dilatation of the stomach may be acute or chronic. The acute condition constitutes a distinct disease, and is seldom if ever associated with cancer of the organ. Chronic dilatation may be obstructi...
- Obstructive Dilatation
- Although dilatation of the stomach has been recognised for centuries as a pathological entity, its full importance was not appreciated until the latter fourth of the nineteenth century, when Kussmaul ...
- Chapter VIII. Operations For Gastric Cancer
- (1) Simple exploratory incision. (2) Gastrectomy. (a) Partial. (b) Complete. (3) Gastroenterostomy. (4) Gastrostomy. (5) Jejunostomy. ...
- Exploratory Incision
- Although exploratory incision for the purpose of making a diagnosis is, as a rule, undesirable, in certain cases the operation is not only justifiable but strongly to be urged. Whenever cancer of the ...
- Operation
- If there is time to prepare the patient it is desirable that the condition of the mouth should be attended to, and that aseptic foods should be given for forty-eight hours before operation. To this en...
- Chapter IX. Gastrectomy
- Although so far back as 1810 Merrem, operating on a clog, showed the possibility of a successful removal of the pylorus, the operation was not performed on man until April 9th, 1879, by Pean, the firs...
- Partial Gastrectomy Of The Pyloric End Of The Stomach
- I have not used the term pylorectomy, as the simple removal of the pylorus is only justifiable in non-malignant disease, such as chronic ulcer. Whenever the disease is thought to be malignant a mor...
- Partial Gastrectomy Of The Pyloric End Of The Stomach. Part 2
- The method is as follows : While the clamps are still in position a long chromic catgut suture is passed through all the coats of the cut stomach wall, beginning at the upper end. This is carried down...
- Partial Gastrectomy Of The Pyloric End Of The Stomach. Part 3
- In making this statement it has, however, to be borne in mind that in case of recurrence the places of section of the viscera will be the most likely sites of return growth, which would in that case l...
- Partial Gastrectomy Of The Pyloric End Of The Stomach. Part 4
- The curved intestinal needles I use for all visceral suturing I have also employed since 1884, and with slight modification in size and thickness they have done me very good service. I never use a nee...
- Chapter X. Indications For The Performance Of Gastroenterostomy In Malignant Disease Of The Stomach
- (a) In dilatation of the stomach due to stenosis of the pylorus from cancer, where the disease is too diffused or the glands are too much involved for successful gastrectomy. (b) The operation of g...
- The Operation Of Gastroenterostomy
- The operation of gastroenterostomy was first performed by Wolfler at the suggestion of Nicoladini on September 28th, 1881. The patient, who was suffering from cancer of the pylorus, lived for four mon...
- The Preparation Of The Patient
- It has been the custom with many surgeons to put patients suffering from disease of the stomach through a long course of preliminary treatment, such as frequent lavage of the stomach and abstention fr...
- Anterior Gastro-Enterostomy
- Anterior gastroenterostomy is performed like the posterior, except that in this case the anastomosis of the jejunum with the stomach is made at the lower border of the anterior surface, and instead of...
- Entero-Anastomosis Of The Jejunal Loop
- This operation has been suggested as a means of preventing the vicious circle or of arresting it should it unfortunately have occurred. In posterior gastroenterostomy without a loop, or with a very...
- Roux's Operation
- This method, which is also spoken of as the Y operation, was suggested and carried out by Roux, and is, I believe, still performed by him and by some other operators as a routine procedure. At the ...
- Roux's Operation. Part 2
- The time that a patient is kept in bed varies with the nature of the case. Old people, especially cancer patients, may often be allowed to sit up in a chair about the tenth day, though they may be mov...
- Roux's Operation. Part 3
- There have been a number of cases recorded (14) in which closure of the artificial opening has occurred within a short time after the use of Laplace's forceps, and in others at a later time after the ...
- Roux's Operation. Part 4
- Though peptic ulcer of the jejunum is less frequent after posterior gastroenterostomy, only two cases having been recorded, when it does occur it is more likely to be acute and not to be limited by ad...
- Roux's Operation. Part 5
- In the operation I have described such an accident could not occur, as there is no long jejunal loop. (8) Death From Asthenia In the eighties and early nineties it was considered absolutely esse...
- Chapter XI. Gastrostomy
- The operation of gastrostomy is designed to make an artificial opening in the stomach, through which a patient may be fed when, for various reasons, food cannot be taken in the ordinary way. It was fi...
- E. J. Sennas method
- The stomach being exposed, an incision about 1 in. in length is made into its cavity as near the cardia as possible, and midway between the greater and lesser curvatures. A tube equal to a No. 12 or N...
- Witzels Method
- An incision, parallel to the costal margin, is made until the rectus muscle is reached. The fibres of the muscle are split vertically and the peritoneum opened. The stomach is exposed and drawn out of...
- Kader's Method
- The stomach is exposed through Fenger's incision, a cut is made into it, and a tube introduced and fixed by a single catgut stitch. Two parallel folds of the stomach are then raised up, one on each si...
- Depage Method
- A. Depage (4) devised the following operation, which he successfully performed in a case of cancer of the upper part of the oesophagus when solid food could not be taken : A vertical incision 7 or 8 c...
- Chapter XII. Jejunostomy
- Jejunostomy is an operation occasionally called for as a means of giving relief and prolonging life in patients suffering from advanced disease of the stomach, where on exploration it is discovered to...
- Jejunostomy Operation
- For any operation to be a success the bowel must be so placed that it will serve the two purposes : (1) To permit the passage onward of the bile and pancreatic fluid poured into the intestine above...
- Chapter XIII. Gastroesophagostomy
- In certain cases of impermeable cicatricial stenosis of the lower end of the oesophagus, and in case of cancerous stenosis, whether involving the oesophagus alone or the cardiac end of the stomach alo...
