Nephrectomy : its indications and contraindications / by Samuel W. Gross.
- Samuel Weissell Gross
- Date:
- 1885
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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![am] primary liemorrha^e, which were the causes of upwards of six-tenths of the deatlis after the abdominal operation. Sucli are tlie general statements in regard to nephrectomy; but to draw any conclusions as to the real value of tliis grave operation, it must be considered in connection with the various diseases or lesions for wliicli it has been performed, and compared with otlier modes of treatment. From an extensive acquaintance with the literature of the subject, I liave been long convinced that the kidney has been too frequently removed ; and it is for this reason, as well as for the purpose of comparing the relative value of nephrectomy, nephrotomy, nephrolithotomy, nephrorrhaphy, and otlier surgical measures, and concluding which of these operations should be resorted to in particular cases, that I have undertaken the present inquiry. 1. Suppurative Lesions—For pyonephrosis, pyelitis, and abscess, in- cluding one example of abscess after a shot wound, and one of suppuration following traumatic rupture, the kidney has been removed 50 tiroes,^ with 28 recoveries and 22 deaths, or a mortality of 44 per cent. Of the 40 lumbar operations, 26 recovered and 14, or 35 per cent., succumbed, while of the 9 ventral incisions, 2 recovered and 7, or 77.77 per cent., died. The remaining one case, in which the nature of the operation is unknown, proved fatal. The cause of death was determined in 20, of \\hich 5 were from shock, 2 from shock and disease of the remaining kidney, 4 from septicsemia, and 1 each from pyaemia, primary hemorrhage, secondary hemorrhage, uraemia, suppression of urine, vomiting, peritonitis, convulsions, and exhaustion. In 1 of the fatal lumbar operations the pleura was wounded, while in 2 the peritoneal cavity was opened, and one reco\ered. In 8 cases the kidney had been previously drained by ne- phrotomy, and 7 recovered. Incision with drainage of suppurating kidneys has been practised in 72 cases,^ of which 59 recovered and 13, or 18.02 per cent., died ; 67 were by the lumbar incision, with 12 deaths, and 5, in the hands of Lawson lait, were by the ventral incision, of which 1 perished. Of the 59 sur- vivors, sinuses or fistiihe persist in 19, or 32.20 per cent. 1 The operators were Bardenheuer in 12 eases ; Czerny in 7 cases • Tait and Von Drrcchi’Duleil''n’ ^^‘^*^«>Coaper,DandriWe, D'Antona, 01,1 p i’ Frattina, Israel, Kidd, Lange, Lloyd, Marsh Weir.\vesr:;dWrCr^^^ Studsgaard, Von Bruns, Von MandaeH; 2 The operators were Bryant in 9 cases ; Tait in 7 cases • Thornton in d B!;rI'?htue^,“Snvel7,’Le^^^^ Calender C Goodridge, Gueterbock Holmes Tr i French, L,„e„, L., le, Key., K,.ester, Leejeu, West, Wlllleins, w.lglit, e.el, l„ 1 e»e ’ Weir.](https://iiif.wellcomecollection.org/image/b22380796_0007.jp2/full/800%2C/0/default.jpg)
