External oesothagotomy in the operative treatment of cicatricial stricture of the oesophagus : with a proposition for improving the method of performing internal oesophagotomy / by Willy Meyer.

  • Meyer, Willy, 1858-1932.
Date:
[1892]
Catalogue details

Licence: Public Domain Mark

Credit: External oesothagotomy in the operative treatment of cicatricial stricture of the oesophagus : with a proposition for improving the method of performing internal oesophagotomy / by Willy Meyer. 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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    mate the real value of retrograde dilatation without an in- ternal cutting operation, the result obtained should be re- examined after one to three years. In a number of these cases internal oesophagotomy had, and will still have, to he added, with, of course, not less danger than in any other case. We always are forced to resort to it if the stricture does not yield to larger sizes of the bougie, or if it rapidly recontracts. Among the one hundred clinical cases of cicatricial stricture of the oesophagus selected and reported by von Hacker (l. c.), I find internal oesophagotomy performed fourteen times * (in one case it had to be done twice). In five it had been combined with the external incision (Cases I, XI, XIII [2], LII, XCIX of the tabula; Case XIII is the one just referred to; both operations were done here twice, combined, by Gussenbauer). Of these five cases, three were cured, one died of haemorrhage fifteen days after the operation ; one of mediastinitis, pleuritis, and peritoni- tis on the third day after the operation. (Sands’s patient, mentioned in foot-note, died of shock twelve hours after the operation.) Of the remaining eight, where internal oesopha- gotomy alone had been done, six are reported as cured, one died three months after the operation of suppurative pleu- ritis and pneumonia, another of mediastinitis and pleuritis. Meningitis as a sequela to the operation in question, as ob- served in my case, I found nowhere reported. But even one single case of such a kind gives sufficient proof that, with internal oesophagotomy as heretofore performed, we may well escape the dangers which often, sooner or later, as soon as the tube, which passed through it into the stomach, had been removed. The fistula in the neck may now and then also heal in this way. * In looking up a few of the reported cases in the original, I find that one case of combined oesophagotomy done by Sands (iV. Y. Med. Jour., 1884 p. 534) has not been included in the tabula. (Bov.)