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THE INVASION OF CARCINOMA CERVICIS UTERI INTO THE SURROUNDING TISSUESAND ITS BEARING ON THE MORE RADICAL OPERATIONS FOR THAT DISEASE.

JOHN A. SAMPSON, M.D.
JAMA. 1904;XLIII(19):1359-1368. doi:10.1001/jama.1904.92500190001b.
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OPERATIVE TREATMENT OF CARCINOMA CERVICIS UTERI.  It is evident that hysterectomy alone seldom cures this condition. As, for instance, in 12 of 15 cases in which the more radical operation has been done, the growth was found to have extended beyond the uterus, as has been mentioned in this paper. In the Johns Hopkins Hospital there have been 63 vaginal hysterectomies, with 5 deaths; 26 combined abdominal and vaginal hysterectomies, with 5 deaths, and 67 abdominal hysterectomies, with 16 deaths. The comparison of the percentage of cures and also the primary mortality in these three classes of cases is of no value, for the abdominal or combined abdominal and vaginal operation has in many instances been used instead of the vaginal operation, because the growth was too far advanced for the vaginal route. It can never be hoped that the abdominal operation will be attended with as low a primary mortality as the vaginal; on the other hand, by the vaginal route the wide excision of the parametrium and pelvic lymph nodes is impossible.

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