medical road high rise

Chapter 345

3Chapter 17 Venous blood can't pass

Compared with other surgeries, precision surgery is more demanding, not much more difficult than vascular surgery, and even more complicated than vascular surgery in some respects.

Take this operation as an example. Both the hyoid bone and thyroid cartilage are relatively small bones in the human body. Compared with other operations, operating on the throat requires higher requirements.

Once the strength is a little heavier, it may lead to an extra cut, which will cut off the carotid artery at the back, or injure the surrounding dense nerves.

After spending nearly an hour, Qin Feng completed the resection of the hyoid bone and entered the hypopharynx cavity.

This is the key part of the operation, and the patient's laryngeal cancer tumor is in the hypopharynx cavity.

However, the patient's laryngeal cancer tumor affected a wide area and invaded many places. When Qin Feng removed it, he also needed to remove the part of the throat where the throat cancer tumor was attached, that is, uproot it.

"Rattooth pliers."

Qin Feng enters from the valley of the epiglottis, and uses a scalpel to incise from the upper edge of the hyoid bone that has been resected, reaching above the lingual surface of the epiglottis.

After clamping the epiglottis with rat-tooth forceps, Qin Feng carefully pulled the epiglottis out and cut along both sides of the epiglottis to completely expose the hypopharyngeal cavity to the surgical field.

"Wait!" The throat doctor suddenly stopped Qin Feng's movements, "Keep this movement."

The laryngologist looked closer, and his face changed: "The patient's epiglottis has been invaded by cancer cells."

Qin Feng will slowly put the anguish back. Once cancer cells invade, it means that the incision cannot be made from this part, otherwise the cancer cells may spread in a large area.

"Change the pear-shaped fossa approach." Qin Feng said.

Although the epiglottic valley was violated, which was a bit unexpected to Qin Feng, it did not affect the overall situation.

Not here, there are other places to enter.

When Qin Feng was making a surgical plan, he couldn't focus on one place. Surgery could cause accidents at any time, and the doctor was the one who dealt with the accidents.

After re-entering from the pyriform sinus, Qin Feng began to check for laryngeal cancer.

Examination of laryngeal cancer requires resection according to the extent of the cancer. This is the most important step in surgery, and it is also the most difficult.

Although X-rays have been taken before the operation, it is still necessary to open the operation area for specific exploration in order to finally confirm the extent of the cancer.

Tumors are something that may change at any time, and you don't know how fast it is.

During Qin Feng's examination, he found that the thyroid cartilage had also been violated. These violated areas must be removed.

It was carefully removed with a scalpel, and then the examination of the entire cancerous tumor was successfully completed.

"Starting to remove the tumor."

After receiving the cut from the equipment nurse, Qin Feng carefully cut the epiglottis in front of the cartilage on the opposite side of the cancer, reaching the throat cavity.

Then, from back to front, cut along the side wall of the laryngeal chamber above the vocal cords to the anterior commissure, and then cut the ipsilateral side with the same method, and the opening continued to the anterior commissure.

As the surgical field continued to expand, internal tumors also appeared in front of everyone.

It's just that this tumor has been glued to the common carotid artery, and the tumor is relatively scattered, with attachments to the carotid artery and all important blood vessels.

The most important thing is that these blood vessels cannot be damaged, and they are also very important to the human body, and the blood vessels are very thin, which is also very fragile compared with a scalpel.

It can be said that this operation is extremely difficult to peel off.

Because it is too difficult to resect the blood vessel tumor on the flowing blood vessel without causing major damage to the blood vessel.

Even if the dissection is successful, it is necessary to find branch blood vessels from the cervical arteries and perform skin flap transplantation.

Now the condition of the patient's throat is already bloody and bloody. It is impossible to tell where are the blood vessels and where are the nerves, where are the muscles and where are the tumors. You need to judge by yourself.

Qin Feng took a deep breath and asked the equipment nurse to wipe his sweat.

Although this step is difficult, as long as it is completed, the operation is more than half successful.

Qin Feng cut the knife and gradually peeled it off, while the laryngologist on the side watched intently.

Every time the knife is cut, everyone's nerves are mobilized.

Fortunately, the result was good, the tumor was successfully stripped off, and the next step was to fix the vocal cords and so on.

With the removal of the tumor, the atmosphere of the whole operation becomes more relaxed.

Qin Feng connected the transverse carotid artery and the transplanted anterolateral femoral skin flap, then left the drainage tube, fixed it in the skin on the side of the neck, and gradually sutured the upper and lower hyoid muscles that had been cut off before.

This operation was performed by Qin Feng throughout the whole process, which lasted for seven hours.

Qin Feng's mental energy consumption is still quite large, and he checked the flow of venous blood, but found a big problem again.

Qin Feng found that the patient's venous blood flow could not pass through, that is, where the transverse cervical artery and the anterolateral femoral flap were connected. There was still no expected venous blood outflow.

The atmosphere in the operating room became tense again.

Without vein outflow, it means that the flap transplantation of this operation has failed, which means that all surgical steps must be repeated.

Even Qin Feng can't guarantee that he can do it so perfectly the second time!
Not to mention whether Qin Feng can continue the operation, even the patient's body does not allow it!
Now the most deadly problem is here, and the cause cannot be found at all.

Qin Feng's breathing became rapid.

"Doctor Qin, do you need to do it again?" the laryngologist asked.

Li Xuewen also looked at Qin Feng, the operation, Qin Feng did it perfectly, but man's calculation is not as good as heaven's calculation.

Qin Feng didn't speak, but stared at the patient's veins. Qin Feng went through his operation process in his mind, trying to find the problem.

Qin Feng didn't show off his skills in this operation, and he did it slowly while ensuring the quality.

However, after quickly reviewing the operation process, Qin Feng found that there was nothing wrong with him!

So, where is the problem?
If this problem is not solved, 100% of the patients will die.

Qin Feng suddenly felt that the pressure doubled, which was much greater than the pressure before going to the operating table.

"Calm down." Li Xuewen said in time.

Now Qin Feng's heart is in a mess. As an experienced doctor, Li Xuewen has seen Qin Feng's situation.

The more this is the case, the less anxious the chief surgeon should be, and he can only think of a solution slowly.

"Think about it, is it possible that the blood vessels are poorly sutured or there is a blood clot in the blood vessels, or..." Li Xuewen kept talking, trying to bring some inspiration to Qin Feng.

Sometimes doctors are like this. They only need a fulcrum to lift the "earth".

Qin Feng looked back at the monitor and frowned. It seemed that before the operation, the patient's blood pressure seemed a bit low, but it did not reach the standard for shock. Is it possible...

(End of this chapter)