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Article
November 25, 1905

TRANSPERITONEAL LIGATION OF THE RENAL VESSELSAS A PRELIMINARY TO A LUMBAR NEPHRECTOMY IN TUBERCULOSIS OR MALIGNANT GROWTHS OF THE KIDNEY.

Author Affiliations

Associate in Surgery, Johns Hopkins University. BALTIMORE.

JAMA. 1905;XLV(22):1647. doi:10.1001/jama.1905.52510220033001j

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Abstract

A recent somewhat exhaustive study of tuberculosis of the kidney, the results of which have been published elsewhere, necessitated the examination of a large number of pathologic specimens, not only of renal tuberculosis but also of malignant tumors, in the Johns Hopkins Pathological Laboratory. From a careful analysis of over 400 cases of renal tuberculosis which I have collected from the literature and from personal observations on a number of instances of tuberculosis and malignant growth, I have been led to conclude that in the course of a lumbar nephrectomy for either of these two conditions, the operator is liable to squeeze tuberculous or malignant material into the general circulation and thereby cause an infection or metastasis. This conclusion is based on the following facts:

First.  —Microscopic examination of numerous specimens of renal tuberculosis showed that the lymphatic vessels and the capillaries not infrequently end very near the tuberculous area.

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