medical road high rise

Chapter 287 Combined Surgery
Invincible Chapter 288
Qin Feng returned to the outpatient clinic after dealing with the patient.

Before Qin Feng sat down, the phone rang.

"The general surgery department has admitted a patient with hepatic hydatid, but the thoracic surgery department has no one to come. Let you go and have a look." This call was made by Zhao Guoping.

Qin Feng agreed, and after inquiring about the office, he went straight over.

Thinking about hepatic echinococcosis, hepatic echinococcosis is a serious zoonotic disease in which poultry is the main source of infection.

Contact with sick poultry or ingestion of food or water contaminated by eggs is also the main way of getting sick.

When Qin Feng arrived at the general surgery department, the doctors from the urology department and the vascular department had already arrived.

"Professor Xie, Professor Wang, and Professor Zhao." Qin Feng greeted.

"Xiao Qin is here, sit down." Professor Xie from the General Surgery Department told Qin Feng to sit down.

Everyone began to discuss the situation about liver echinococcosis.

"This patient was sent to our general surgery department in the morning. In the afternoon, he broke through the rupture of the liver capsule and underwent a CT scan. It was found that the chest cavity, abdominal cavity, and portal vein were all eroded by hydatid." Professor Xie said.

Everyone frowned, the thoracic and abdominal cavities and the portal veins were all eroded, which required joint operations from many departments.

The first is combined thoracoabdominal resection, and the portal vein needs to be diverted, so TIPS surgery is needed to devascularize the portal vein.

Because whether it is liver hydatid or malignant tumor, once the portal vein is invaded, the difficulty of surgery will increase geometrically.

Professor Xie turned on the CT on the projection, and on the CT image, a small snake appeared in a group of "gauze".

In the "European Journal of Radiology", the most obvious impact on the diagnosis of acute abdomen with ruptured liver cysts is the snake-like shape and the gauze shape.

After observing the area where the "gauze" was located, Qin Feng found that the liver hydatid disease had eroded a wide range, involving abdominal and thoracic organs and important blood vessels. Looking at the images, it was more terrifying than cancer.

Seeing the erosion of the chest cavity, Qin Feng felt that it should be the septic shock caused by the cyst rupture on the right side of the chest cavity.

Everyone present felt that this operation was difficult.

Even if everyone joins the operation, the chance of the patient getting off the operating table is not high, it is estimated that it is only about 5%.

This probability is almost the same as winning the lottery. For doctors, it is survival.

"This operation, I think it's better to give up." Professor Wang from the Department of Vascular Surgery said, "The patient was picked up by your general surgery department. Once the operation fails..."

Professor Wang didn't say much about the latter.

For this kind of patients who do not do or die, and only about 5% of patients hope to survive after doing it, most doctors will choose to give up.

In addition, the identity of the patient is quite complicated. He is an anonymous person. It is good that the operation is successful. Once the operation fails and some relatives appear, the hospital will not be able to resist.

"Don't worry about this, the medical department has already filed a record, and we won't be held responsible if something goes wrong." Professor Xie said.

Even if Professor Xie said so, Professor Wang still shook his head, not optimistic about the operation.

Professor Zhao on the side did not make any comments like Qin Feng, but just looked at CT quietly.

"Xiao Qin, what do you think?" Professor Xie asked, lighting a cigarette.

"I think it can be done." Qin Feng said, "I want to know if the hospital has liver transplants or is it going to adopt autologous transplants?"

"There is no suitable liver source, and the patient's identity information is unknown, so we can only choose autologous transplantation." Professor Xie said.

After all, the patient was picked up. It is impossible for the hospital to waste the liver source on him. A liver source is worth a lot of money, so it is impossible to take it out just because of one patient.

Qin Feng nodded, expressing his understanding.

"Leave the autologous transplantation to me." Qin Feng said firmly.

As soon as this sentence came out, the three directors all looked at Qin Feng.

Another reason why Professor Wang is not optimistic is that the key to this operation is autologous transplantation, not other operations.

If the intervention cannot keep up, the patient will undoubtedly die.

"Are you sure?" Professor Wang frowned.

This is no joke, if you are not careful, the patient will die on the operating table.

"I'm sure."

"That's fine, since Xiao Qin has undertaken the most difficult operation, I also decided to agree to the operation." Professor Xie said.

"I agree too." Director Zhao, who had been silent all this time, also raised his hand.

The rest, Professor Wang, sighed helplessly and agreed.

"I hope you can do the portal surgery well." Professor Wang said.

Everyone tidied up and headed towards the operating room.

Since it was a multidisciplinary operation, Professor Xie was the first to take the stage.

Once the surgery was confirmed, these director and professor-level doctors did not hesitate, and all of them went all out.

When the operation started, Qin Feng stood behind Professor Xie and watched Professor Xie's operation.

This was Qin Feng's first time watching someone else's operation in Ruijin Hospital, and it was a bit novel.

Professor Xie made a traditional incision and bluntly dissected the posterior approach to expose the kidney.

Looking at the appearance of the kidney, Qin Feng took a breath.

The patient's kidney is no longer like a human kidney, but like a farmland full of cauliflower. Those cauliflower-shaped hydatid vesicles are like a typical malignant tumor, wrapping the kidney tightly, giving people A feeling of nowhere to start.

Professor Xie himself also felt nauseated, and insisted on removing the kidney segment first.

It has to be said that the level of professor-level doctors in Ruijin Hospital is quite high.

The speed of separating the renal pelvis and calices is not slow at all. After the renal segment is resected, it is sutured.

This is only the first step. Professor Xie still needs to perform liver resection, gallbladder removal, and exposure of the second porta hepatis to prepare for the vascular surgery.

After Professor Xie opened the abdominal cavity, the situation inside was even worse than Qin Feng imagined.

At least 60% of the entire liver was eroded by hepatic echinococcosis, and near the second portal of the liver, there were gray-white vesicles that made the scalp tingle.

Some terrified people see this scene and feel that they will be too frightened to sleep at night.

Professor Xie restrained his expression, put gauze on the incision and the surrounding organs of the cyst, and then covered it with a layer of gauze soaked in 10% formaldehyde solution. This is to prevent the vesicles from bursting and the cyst fluid from spreading to cause secondary pollution and cause allergic reactions.

Two traction threads were sewed on the cyst wall. Professor Xie picked up the puncture needle to puncture between the two threads, sucked part of the fluid in the cyst, and pulled out the puncture needle after observing and confirming that it was a hydatid cyst.

Connect the trocar handle to the Y-shaped tube, connect it to the syringe and aspirator respectively, then use a hemostatic forceps to clamp the rubber tube of the syringe, and then insert the trocar needle into the cyst cavity along the puncture site to drain the liquid inside the cyst. Aspirate.

After dealing with all this, Professor Xie's movements also stopped.

He found that he couldn't find the second porta hepatis, mainly because those vesicles affected the surgical field too much.

(End of this chapter)