The surgical treatment of chronic lymphedema (elephantiasis)

286 present, sionally

AMERICAN

coronary in cases

Roentgenoscopy suspect. It may are negative,

occlusion of aortic

HEART

JOURNAL

should be suspected. Bystolic expansion insufficiency with cardiac enlargement.

should form part of the routine examination be positive when the physical examination and

is seen

occa-

of every cardiac electrocardiogram AUTHOR.

Sheehan, Carotid

the this

D., Mulhollaud, Sinus

Nerve.

J. II., and Fhafiroff, Anat.

Rec.

80:

431,

B.:

Surgical

The common variations of the carotid sinus nerve and carotid body have been described, based on thirty-three region.

The carotid sinus is innervated sympathetic, and exceptionally by two ways, (1) along the carotid plexus and the carotid body.

by the glossopharyngeal, the hypoglossal. The sinus nerve and (2)

The anatomy suggests the feasibility preference to extensive stripping of the of carotid sinus syncope.

Anatomy

of the

1941.

of dividing carotid artery,

of the special

innervation dissections

of of

vagus and cervical fibers reach the sinus in through an intercarotid

the carotid sinus nerve in in the surgical treatment AUTHORS.

Hyman, A., and Leiter, H. E.: Surgery Conditions. J. Ural. 45: 813, 1941.

of the Inferior

Vena Cava in Urologic

A series of eleven surgical procedures on the vena cava is reported. Experimental and surgical procedures demonstrate that complete ligation of the cava below the renal veins is compatible with life. In this series the vena cava was accidentally injured in four instances, whereas in the other seven cases the surgery was deliberate. It may be stated that the deliberate type of surgery on the cava is generally associated with renal neoplasm,s or adherent pyonephrotic kidneys. With the newer sulfanilamide preparations in general use, the indications for surgery on the cava in inflammatory conditions will be reduced to a minimum. Tn these eleven eases there were three postoperative deaths. As stressed in this paper, the renal vein and vena cava should always be explored in right renal neoplasms. For this reason, a wide exposure, necessitating resection of one or two ribs, is advisable. In some of the cases reported patients have survived a threeyear period where thrombi have been removed from the vena cava. The presence of a vena cava tumor thrombus, while certainly grave, does not necessarily imply an immediate fatal course. AUTHORS.

Pratt, G. II., and Wright I. S.: The Surgical Treatment (Elephautiasis). Surg., Gynec. & Obst. 72: 244, 1941.

of Chronic Lymphedema

A surgical procedure is described for the treatmetit of chronic lymphedema. The importance of proper preoperative preparation is stressed. About threefourths ‘of the circumference of the superficial and deep fascia are excised en mabse. A broad-based pedicle tube graft is employed where it is necessary to In addition to skin replacement, the pedicled graft remove devitalized skin. drains the skin lymphaties and thus supplies a new method of aiding skin lymphatic drainage. NAIDE.