I'm a god of medicine

Chapter 626 Doctors should have a conscience

a new day.

Vice President Kong Dexing of the Affiliated Hospital of Jiangxi Medical University walked into the operating room of the hospital energetically.

Today, there is an important operation that must be performed by him himself.

The patient is a relative of Director Gong of the Nephrology Department of our hospital, and the disease he suffers from is retroperitoneal tumor.

The position of the retroperitoneum is deep, and because of the large space in the abdominal cavity, the mass effect of the initial tumor is not obvious.The clinical symptoms are mostly soreness in the lower back, which is often mistaken for muscle strain in the lower back and delays the condition.

The relative patient of Director Gong’s family is a female. She just passed her 30th birthday in September last year. In the past two months, she has obviously felt that her belly has become bigger. At first, she thought she was pregnant with a second child, but she went to a nearby community hospital for checkups twice. Both showed hcg negative.

As a last resort, I came to Jiang Medical Affiliated Hospital to find Director Gong.

The diagnosis is very simple. After a B-ultrasound examination, the cause will be clear. However, whether the retroperitoneal tumor is benign or malignant cannot be judged by B-ultrasound.

However, be it good or evil, the first treatment for this disease is of course surgical resection.

So Director Gong took his relatives to find Vice President Kong.

Retroperitoneal tumors... Well, compared with intra-abdominal tumors, the operation is much more difficult, but for me, Vice President Kong, it is not a big problem.

After arranging for the patient to undergo a further abdominal CT examination, Kong Dexing took the film and looked at it carefully, then easily made a judgment and accepted the patient.

Vice President Kong's ability to read CT films is quite good, but the results of imaging examinations cannot reflect the true condition of the lesion [-]% accurately.

Vice President Kong also fully considered this point before the operation.

He did not go to college, but organized three MDTs before the operation, involving subjects other than hepatobiliary surgery, spine surgery, gastrointestinal surgery, vascular surgery, and urology.

Based on the opinions of experts from various disciplines, the operation plan was revised several times until the operation was performed on the stage today.

The laparotomy was performed smoothly, the abdominal viscera were freed, and the retroperitoneum was exposed.

The retroperitoneum was opened, and the living tissue was taken and sent to the pathology department for rapid intraoperative pathological diagnosis, and then the operative field was expanded to explore the extent of tumor invasion.

Kong Dexing's expression gradually became serious.

If the difficulty of the operation assessed before the operation was seven to eight on a ten-point scale, it now appears that the difficulty has already exceeded ten, and with the deepening of the investigation, the difficulty seems to be increasing.

This tumor is not a whole, but as many as dozens of tumors stick together, which makes the CT image misleading.

The entire retroperitoneal space was invaded and filled by the tumor, including the root of the superior and inferior mesenteric artery, the root of the celiac trunk of the aorta, the root of the renal artery and vein, and other important blood vessels, all of which were also wrapped in the tumor.

Cut, still can cut.

But want to cut clean...

Kong Dexing couldn't help shaking his head on the operating table.

If there is a surgical robot, then it may be able to cut cleanly with a little more time, but if it is done with bare hands, I am afraid...

A name suddenly appeared in Kong Dexing's mind.

Yang Xi!

I'm afraid only that evil Yang Xi can do it.

Thinking of Yang Xi, Kong Dexing couldn't help feeling angry.Scenes of the live broadcast of the training doctor skills competition more than two months ago unconsciously appeared before my eyes.

It's no wonder that Junior Brother Qin treats him like that. This bastard is really disgusting. In his heart, there is no respect for seniors, teachers, and elders. As long as it is beneficial to him, as long as it can satisfy his vanity, Anyone can be trampled under his feet without giving him any face.

Today, if he begged in front of that bastard because of this operation, how would he humiliate me, Lao Kong?
forget it.

Last time in that live broadcast match, it was already embarrassing enough. This time, I must not take the initiative to give that bastard a chance again!
Twenty minutes later, the pathology department sent a diagnosis report, Ganglion Cell Neurofibroma.

Kong Dexing's head suddenly became dizzy.

Retroperitoneal tumors are mostly malignant, especially the case with rapid tumor growth like the one on stage.If it is a malignant tumor, whether it is cut clean or not has little effect on the prognosis of the patient.

Like this kind of malignant tumor located in the retroperitoneum, the so-called clean cut is just what the surgeon can see with the naked eye, but in fact, there are still a lot of tumor cells remaining in the retroperitoneal space.Therefore, as long as reasonable chemotherapy and radiotherapy are given after surgery, there is almost no difference in the survival rate of patients.

However, this neurofibroma is a benign tumor.

If it is purely benign, there is no need to worry if it is not cut cleanly. However, this is not a purely benign tumor, because if the tumor grows rapidly, it is likely to be malignant.

With such a pathological process, the prognosis of the patient is mostly affected by clean cuts and unclean cuts.

If the cut is clean, there is no need for chemotherapy after surgery, only a supplementary radiotherapy is needed, then the patient is likely to achieve a recovery, and it is not the recovery that the doctor understands, but the recovery that the patient expects, ten years, 20 years, or even more. It will not recur for a long time.

But if the cut is not clean, it cannot be said to be a failed operation, but at least it is not a perfect operation.No matter what kind of radiotherapy and chemotherapy plan is given to the patient after surgery, the possibility of recurrence is far greater than that of the former.

Doctors are benevolent, but more importantly, they must have a conscience.

Kong Dexing hesitated for two or three minutes, first gave up the idea of ​​partial resection, and then vetoed Guan Fu's idea of ​​stepping down and suggesting transfer to another hospital.

Please Yang Xi!

As long as he can do the operation well and give the patient the best result, I, Kong Dexing's old face, can be trampled on by him!
When making this decision, Kong Dexing didn't take Director Gong into consideration at all.

After stepping back from the operating table, Kong Dexing called the relatives of the patient through the videophone in the operating room.

After explaining the situation, the relatives of the patient asked Vice President Kong to wait a little longer. They don't understand medicine and need Director Gong to come to make the decision.

Only then did Kong Dexing realize that the patient was an acquaintance in the hospital.

In 10 minutes, Director Gong hurried to the operating room.

Kong Dexing brought Director Gong to the operating table, asked the assistant to expose the operative field, and explained: "Dozens of lumps have become a lump, including the upper and lower mesenteric arteries, renal arteries and veins, and abdominal aortic trunk. If you want to cut it clean, the risk is too great, but if it is palliative resection, the prognosis for the patient is not very good.”

Director Gong said nervously: "Then Confucius Institute, you mean...or, transfer to Shanghai Magic City?"

Kong Dexing shook his head, and said, "Professor Chen has a surgical robot over there, which can cut it clean, but go to his side, how long will you be waiting in line?"

(End of this chapter)