File:The pathology and surgical treatment of tumors (1895) (14590898559).jpg

Identifier: pathologysurgica1895senn (find matches)
Title: The pathology and surgical treatment of tumors
Year: 1895 (1890s)
Authors: Senn, Nicholas, 1844-1908
Subjects: Neoplasms Neoplasms Cancer Cancer
Publisher: Philadelphia : Saunders
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

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ional infection occurs, as a rule,late, but that it is sure to ensue if the disease is allowed to pursue itsown course. The writer has seen regional infection much more fre-quently in carcinoma of the penis than in carcinoma of the lip. Theinguinal glands on both sides eventually become involved—a fact whichhas led to the conviction that it is necessary in most cases to resort atonce to clearing out of the inguinal glands in all cases of carcinomaof the penis in which a radical operation is performed. CARCINOMA. 345 Amputation of the Penis for Carcinoma.—If the carcinoma is limitedto the prepuce, and no evidences of lymphatic affection are present, theorgan should be amputated behind the corona glandis. The penis isconstricted at its base with a rubber cord or tube to render the opera-tion bloodless. The section through the penis should be made withthe knife in such a manner as to secure for the stump a cutaneouscovering. The writer generally makes an oval anterior flap with which
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Fig. 227.—Papillary carcinoma of penis ; X 10 (after Karg and Schmorl). Between the enlarged papillae,covered by thickened layers of epithelial cells, are found infiltrations of epithelial cells which in the vascularconnective tissue show distinct cancer-nests. to cover the corpora cavernosa. The mucous membrane of the ure-thra is stitched to this flap and to the adjacent skin. The dorsahs penisartery is ligated. The hemorrhage from the corpora cavernosa, at firstprofuse, yields to compression, hot water, and the sutures. A smalldressing held in place with a number of strips of adhesive plaster fin-ishes the operation. Rest for a few days in bed must be enforced.The suturing of the flap and the urethra should be done with fine cat-gut sutures, so as to obviate the necessity of removing them. 346 PATHOLOGY AND TREATMENT OF TUMORS. If the body of the penis is affected by extension of the primarytumor of the prepuce or the glans penis, the organ should be amputatedclose to the pubes, a

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