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Ovarian carcinoma subsequent to hysterectomy
Volun~e 61 Number 5
dosage, and method of administration. Their recommended dose is 0.25 mg. given intramuscularly. Larger doses, they feel, are unnecessary and they may produce excessive uterine activity. The injection may be repeated two or three times at 4-hour or longer intervals but usually two doses are sufficient. HARVEY
B.
MATTHEWS
Malignancies Meigs, Joe Vincent: Transperitoneal pratique
2:
115,
Removal of the Pelvic Lymph Nodes in Cancer of the Cervix. The (Taussig) and Retroperitoneal (Nathanson) Dissection, GynBc. 1951.
Meigs, as an honored guest lecturer before the International Cancer Congress held in Paris in July, 1950, reviews his experiences in gynecic surgery concerned with carcinoma of the cervix uteri. Meigs reiterates that by the use of selected lymphadenectomy operations there can ensue a greater salvage of carcinoma of the cervix cases whose local lesions exhibit postradiation control. Again the author emphasizes that these operative methods of treatment are indicated in selected cases particularly because it is felt that x-ray treatment as given at the present time cannot destroy cancer in the pelvic lymph nodes. He quotes Morton’s, Taussig’s, and Nathanson’s lymph node findings in support of this statement. Meigs admits there exist serious operative dangers but concludes that, in his hands, the mortality and morbidity are minimal. He favors the retroperitoneal approach as possessing several advantages: (a) less risk, (b) wider applicability since it can be done in stages, and (c) better surgical exposure in the obese patients. The writer concludes these operations are in the experimental stage but in the hands of the more qualified gynecologic surgeon they ‘do represent an addition to our operative armamentarium. In his discussion Moigs does observe, (‘surgical dissection of a protected area may break barriers and allow dissemination of the tumor to occur. This phenomenon has been noted in our series and it makes one wonder whether or not surgery by destroying barriers may allow dormant and imprisoned carcinoma to reactivate and spread. ’’ CIAIl%
Thorp,
Donald: 1951.
Ovarian
Carcinoma
Subsequent
to Hysterectomy,
E.
~‘OLSOME
Wost. J. Surg. 59: 440,
A plea is made for the removal of the ovaries at the tinle of hysterectomy. An enthusiastic and brilliant espousal of this surgical philosophy is underscored by the report of ten malignant ueoplasms arising in the ovary left in place after hysterectomy. In a period of five years there were two hundred seventy-six pelvic tumors removed from women upon whom hysterectomy had previously been performed and in whom one or both ovaries had been left. Ten of these tumors were malignant neoplasms which at the time of this report had brought death to five of the patients. The author feels that the best interest of the patient is not served 1)~ leaving the ovary following this operation. He believes that the symptoms of the climacteric following bilatral oophorectomy are no more severe than those following physiological ovarian involution. The ovaries are unpredictable organs and even those which do not undergo malignant change after hysterectomy are all too frequently the site of cystic degeneration which vitiates their possible physiologic usefulness. The author muses on the thousand.6 of appendices which have been removed prophylactically when the worst fate of that organ is inflammation and not malignancy while traditional reverence for the ovaries precludes their removal at a time when their useful function is nullified by removal of the uterus. WILLIAMS
BICKERS
dosage, and method of administration. Their recommended dose is 0.25 mg. given intramuscularly. Larger doses, they feel, are unnecessary and they may produce excessive uterine activity. The injection may be repeated two or three times at 4-hour or longer intervals but usually two doses are sufficient. HARVEY
B.
MATTHEWS
Malignancies Meigs, Joe Vincent: Transperitoneal pratique
2:
115,
Removal of the Pelvic Lymph Nodes in Cancer of the Cervix. The (Taussig) and Retroperitoneal (Nathanson) Dissection, GynBc. 1951.
Meigs, as an honored guest lecturer before the International Cancer Congress held in Paris in July, 1950, reviews his experiences in gynecic surgery concerned with carcinoma of the cervix uteri. Meigs reiterates that by the use of selected lymphadenectomy operations there can ensue a greater salvage of carcinoma of the cervix cases whose local lesions exhibit postradiation control. Again the author emphasizes that these operative methods of treatment are indicated in selected cases particularly because it is felt that x-ray treatment as given at the present time cannot destroy cancer in the pelvic lymph nodes. He quotes Morton’s, Taussig’s, and Nathanson’s lymph node findings in support of this statement. Meigs admits there exist serious operative dangers but concludes that, in his hands, the mortality and morbidity are minimal. He favors the retroperitoneal approach as possessing several advantages: (a) less risk, (b) wider applicability since it can be done in stages, and (c) better surgical exposure in the obese patients. The writer concludes these operations are in the experimental stage but in the hands of the more qualified gynecologic surgeon they ‘do represent an addition to our operative armamentarium. In his discussion Moigs does observe, (‘surgical dissection of a protected area may break barriers and allow dissemination of the tumor to occur. This phenomenon has been noted in our series and it makes one wonder whether or not surgery by destroying barriers may allow dormant and imprisoned carcinoma to reactivate and spread. ’’ CIAIl%
Thorp,
Donald: 1951.
Ovarian
Carcinoma
Subsequent
to Hysterectomy,
E.
~‘OLSOME
Wost. J. Surg. 59: 440,
A plea is made for the removal of the ovaries at the tinle of hysterectomy. An enthusiastic and brilliant espousal of this surgical philosophy is underscored by the report of ten malignant ueoplasms arising in the ovary left in place after hysterectomy. In a period of five years there were two hundred seventy-six pelvic tumors removed from women upon whom hysterectomy had previously been performed and in whom one or both ovaries had been left. Ten of these tumors were malignant neoplasms which at the time of this report had brought death to five of the patients. The author feels that the best interest of the patient is not served 1)~ leaving the ovary following this operation. He believes that the symptoms of the climacteric following bilatral oophorectomy are no more severe than those following physiological ovarian involution. The ovaries are unpredictable organs and even those which do not undergo malignant change after hysterectomy are all too frequently the site of cystic degeneration which vitiates their possible physiologic usefulness. The author muses on the thousand.6 of appendices which have been removed prophylactically when the worst fate of that organ is inflammation and not malignancy while traditional reverence for the ovaries precludes their removal at a time when their useful function is nullified by removal of the uterus. WILLIAMS
BICKERS