One of the fundamental principles of present day, surgery is the conservation of the patient's strength. This is particularly true of the patient who presents a bad risk. The operative mortality in thyrotomy for epithelioma of the larynx is extremely low, and when death does occur, the patient usually presented a bad surgical risk, either because of advanced age or disease. It is in these cases of bad surgical risk that I believe two-stage thyrotomy is indicated; the patient receives less postoperative reaction than in the one-stage operation.
In 1922, Jackson1 reported forty-five cases in which thyrotomy was done without operative deaths. Thomson2 reported an operative mortality rate of 4 per cent in seventy cases in which laryngofissure was performed. He said, however, that laryngofissure is much more frequently fatal than complete laryngectomy.3 Tucker4 reported one operative death in fifteen cases. During the last four
NEW GB. TWO-STAGE THYROTOMY IN CASES CONSIDERED BAD RISKS. Arch Otolaryngol. 1929;9(5):538–542. doi:10.1001/archotol.1929.00620030564007
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