Medical Record Volume 94, Nos. 13-26

Medical Record Volume 94, Nos. 13-26

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This historic book may have numerous typos and missing text. Purchasers can usually download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1918 edition. Excerpt: ...a malignant degeneration. In considering the indications for operation and the surgical problems to be met in the operative treatment of malignant thyroid tumors, it may first be stated that when the clinical diagnosis is positive, surgical interference should be advocated only under exceptional circumstances. In our own experience, at least, infiltrating, diffuse, advanced cancer of the thyroid, when the capsule has been perforated and muscles and glands involved, has never been cured even by the most radical methods, and such methods are attended by a prohibitive risk. Under such conditions, therefore, the only purpose of surgery would be the relief by tracheotomy of tracheal pressure with actual or impending suffocation, and even this procedure may be one of considerable technical difiiculty, great risk, and dubious results. As a rule, therefore, it is much better to advise the use of radium, roentgen ray exposures, and whatever other palliative measures there are available. Even when the malignant process is less extensive and the anterior and lateral relationships of the gland make it appear possible and reasonably safe to remove the entire gland, it is important to remember that there is a liability to encroachment of the disease on the trachea, the esophagus, or both. This complication may vary between actual invasion of these structures and firm attachment to them without involvement. In the first complication the possibility of obtaining a cure is rendered very unlikely, although we have had one case in which the lateral wall of both the trachea and the esophagus was excised with the thyroid; the patient is alive and well seven years afterwards. In the second complication, the malignant mass may be crowded between the trachea more

Product details

  • Paperback | 710 pages
  • 189 x 246 x 36mm | 1,247g
  • United States
  • English
  • black & white illustrations
  • 1236807081
  • 9781236807083