Surgery, gynecology & obstetrics
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Carcinoma of the colon and rectum metastasizes readily to the ovaries, and oophorectomy during operation upon the colon and rectum remains an effective surgical technique for precluding subsequent oophorectomy and, thereby, diminishing the morbidity of carcinoma of the colon and rectum in women. This procedure does not significantly affect the survival rate. Carcinoma of the ovary has become the fourth most common lethal cancer in women. ⋯ The five year survival rate remains about 30 per cent. The incidence of carcinoma of the ovary in women with carcinoma of the colon and rectum is roughly five times the incidence of carcinoma of the ovary, that would be expected by chance. We believe the aforementioned observations strongly expand and reinforce the original proponents of prophylactic oophorectomy performed upon women with carcinoma of the colon and rectum and that, therefore, oophorectomy should be an integral part of operation upon the colon and rectum in women.
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Peritoneal lavage has become widely accepted in the management of blunt abdominal trauma, but its role has not been clearly established in the evaluation of penetrating abdominal injuries. The interpretation of lavage effluent analysis and the criterion for laparotomy are also unclear. A review of our recent experience and that of other indicates that peritoneal lavage has a significant role in detecting intra-abdominal injury from abdominal stab wounds and penetrating injuries of the lower part of the chest. ⋯ It is of negligible value in the evaluation of penetrating trauma to the back and flank. Quantitation of erythrocytes in the lavage effluent is the most reliable indication of intra-abdominal injury, and the level of significance varies according to the mechanism and location of the injury. The usefulness of other analysis of the effluent remains undetermined.