Edgar J. Poth

Plication in the surgical treatment of chronic recurrent intestinal obstruction

Abstract The basic principles by which plication corrects small bowel obstruction caused primarily by intra-abdominal adhesions are presented. The technic originally suggested by Noble and modified by Childs is discussed together with the results obtained in 132 patients. The management of the patient through what might prove a trying convalescence is described.

Minimal surgical treatment of the complications of duodenal ulcer

Abstract The great variability of duodenal ulcers and the treatment needed to control the disease are discussed. These variations are related to the physiologic functions of the stomach and duodenum. The variability of the results obtained by simple gastrojejunostomy is discussed and evaluated with respect to recent physiologic information. The proposition is made that the majority of patients needing surgical care really require minimal assistance and should not be subjected to overtreatment. Staged, graded treatment is advocated. Experiences with gastroduodenostomy are presented, and it is urged that this general procedure be subjected to rigid evaluation. This plea is being made for the large majority of patients with complications of duodenal ulcer who require surgical assistance but who need minimal help. Overtreatment in these patients may precipitate a significant percentage of irrevocable conditions. The patient who needs no more than minimal surgical aid is truly well again and is restored to a normal life. It is unfortunate that these persons cannot be identified by nonoperative diagnostic means, but instead the small minority needing more extensive treatment must be subjected to graded or staged operations to avoid blind overtreatment of the majority.

Current operative treatment of carcinoma of the breast and its rationale

Abstract 1. 1. The results after radical mastectomy have changed little since the procedure was introduced by Halsted. 2. 2. Classification of carcinoma of the breast by clinical staging is most useful in determining therapy and comparing results in statistically significant case studies. 3. 3. The acceptability of simple mastectomy for carcinoma confined to the breast has recently gained many responsible adherents. 4. 4. The futility of radical mastectomy in the inoperable lesion is generally accepted. Extended radical operation with excision of the internal mammary nodes may contribute to further knowledge of the disease. 5. 5. The possibility of realizing comparable therapeutic results by minimal surgical intervention dictates thorough evaluation. 6. 6. The immunologic significance of the lymphatics in relation to carcinoma of the breast needs further investigation. 7. 7. A cooperative study which will rapidly supply a large series of cases is proposed to examine more fully the effectiveness of simple mastectomy in stage I and stage II lesions.