I'm a god of medicine

Chapter 271 What's going on?Where is the blood oozing?

The difficulty of the third laparoscopic operation returned to the normal level, and Yang Xi solved the battle in 20 minutes.

Look at the wall clock on the wall, it's not even ten twenty.

Although the surgery video was over, the audience in the live broadcast room refused to disperse. They stayed for only one purpose, to express their emotions after being shocked.

Looking at the total number of fans he has skyrocketed, Yin Wei couldn't help raising the corners of his mouth. How many fans does Professor Su Dongming Su's Xinglinyuan account have?Isn't it just over [-], what's so awesome, I, Yin Wei, can surpass him in at most three months!
The number of followers of a doctor in charge of a city-level hospital on a professional website like Xinglinyuan surpasses that of a well-known domestic expert from a provincial hospital like Professor Su Dongmingsu, and the corners of Yin Wei's mouth are almost raised to his cheekbones.

Thinking back to a month ago, there were only [-] pitiful fans under the name of 'Anesthesiology Yin Wei', half of them were colleagues from the hospital, and the other half were good classmates... Yin Wei shivered suddenly, not because of that. Yes, the shabby state, but thought of the danger in the future.

That evildoer, if he personally created an account in Xinglin Garden, would he still be able to play by himself?
No!

You have to dig a hole to bury that kid, so that he will never jump out of your palm... The expression conveyed by the corner of Yin Wei's raised mouth changed from smug to ferocious in seconds.

……

In the operating room next door, a rectal cancer operation is being performed.

There are many surgical methods for rectal cancer, such as transabdominal anterior resection of rectal cancer, combined abdominoperineal resection with preservation of the anal sphincter, combined abdominoperineal resection, etc., but in summary, they can be basically divided into anus-preserving surgery and non-preserving surgery. anal surgery.Surgeons also have a lot of debates about the choice of surgical methods, mainly focusing on the distance between the middle and lower rectal cancer and the anal sphincter. Should the anus and its function be preserved to ensure the quality of life of patients after surgery, or should they be abandoned? Anus and its function to ensure the thoroughness of the operation.

At present, the definition standard recognized by most doctors is whether the distance between the lower edge of the cancer and the anal edge (dentate line) has reached 7 cm. If it is more than 7 cm, anus-preserving surgery can be used, and if it is less than 7 cm, it is best. Take non-anal surgery.

The patient Guo Keyuan took in happened to be on the 7 cm limit, which made Guo Keyuan very embarrassed.If it is from the wishes of the patient or the patient's family, it is definitely necessary to pursue anal sphincter surgery. No one wants to have to wear a feces bag around the waist all day long. I can't even stand it because I hate myself.

However, what do patients or their family members know?

From a medical point of view, at such a distance, forcibly adopting anus-preserving surgery will inevitably sacrifice part of the thoroughness of surgical resection, and if the surgery cannot completely remove the extent of tumor invasion, then the postoperative tumor recurrence rate will be quite high. high.

Once rectal cancer recurs in situ, the possibility of reoperation is almost zero.Chemotherapy is not sensitive, and radiotherapy is not enough. At that time, the only choice for patients is targeted drugs.

Targeted drugs are not cheap, even if it is a generic drug that is more than half the price brought by someone from the third brother, it will cost tens of thousands or even tens of thousands of yuan in a month.Moreover, not all patients are suitable for targeted drugs. If the target is negative, it means that this targeted drug is basically ineffective for the patient.

Between life and quality of life, Guo Keyuan finally chose life for the patient.

The operation plan he made for this patient was the classic abdominal perineal resection, also known as Miles operation.The resection range of this operation is very large, including the sigmoid colon and its mesentery, rectum, anal canal, levator ani muscle, tissues in the ischiorectal fossa, and perianal skin and blood vessels.Although the patient has to stay with the feces bag for the rest of his life after the operation, this kind of surgical excision has the highest cure rate and the lowest recurrence rate.

This operation is also the most time-consuming and labor-intensive among all rectal cancer operations. Four surgeons have to be on stage at the same time. For the levator muscle, the two groups met in the ischiorectal fossa, and then separated after the tissue in the fossa was excised. The upper two performed artificial anus, and the lower two performed perianal resection and sealed the anus.

Under normal circumstances, such an operation takes about four hours to complete.

But for Guo Keyuan, he was completely sure that the battle would be resolved within three and a half hours.That is to say, the operation starts at 08:30 in the morning, and the operation can be completed around [-]:[-] noon, so there must be time for lunch.

Just when Yang Xi and the others completed the three laparoscopic operations planned that morning, the two groups of Guo Keyuan's team were preparing to join forces in the ischiorectal fossa.

After completing the resection of the tissue in the ischiorectal fossa, the remaining steps are much simpler. However, when removing the tissue in the ischiorectal fossa, one must be very careful.The back wall is the sacrum, and the vast majority of rectal cancer patients will have hyperplasia of the presacral venous plexus. If one accidentally touches it and breaks it, then don't expect this operation to be completed within three and a half hours. If it is completed within a few days, it may not be able to get off the stage for four hours.

Guo Keyuan has completed the Miles surgery at least [-] times. It should be said that he wants to be rich in experience.

however……

"What's going on? Where is the blood oozing?" When Guo Keyuan muttered this sentence, his heart was already cold. Ten seconds ago, when he bent down the forceps, he didn't know what happened, and his heart suddenly thumped. Twice, causing his hands to tremble slightly.

It's just trembling slightly, so it probably didn't touch the presacral venous plexus!

With a fluke mentality, Guo Keyuan wanted to continue going down, but at this moment, he saw blood oozing in the surgical field.

After observing for a while, Guo Keyuan made a decision. The bleeding was not large, so it could be put aside. After the tissue resection in the ischiorectal fossa was completed, it would be easier to stop the bleeding when he turned back.

Ten minutes later, Guo Keyuan took his assistant to complete the resection of the tissue in the ischiorectal fossa, and came back to look for the bleeding point... The heart that had been half cold was finally cooled.

The bleeding point is located between the loose joints of the sacrum, but the joints are on the side and back of the sacrum. Unless a surgical channel is opened from the patient's back, only bleeding can be seen from the front, but Unable to pinpoint the bleeding point.

There is no other way, but the most stupid way is to stuff the hemostatic gauze and apply pressure to stop the bleeding.

Well, there is no need to think about being able to eat lunch on time. Within half an hour, it will be a high incense to stop the bleeding.

(End of this chapter)