Back in 2002 as a doctor

He was puzzled, and turned sideways to find an angle to see if it was Zhou Congwen.

How could a young doctor from the Third Hospital have such proficient techniques? Impossible, absolutely impossible!

This unscientific!

Moreover, Director Deng of 912 was willing to be his assistant. For a moment, Zhu Jun even suspected that Huang Lao would do double body technique, and that the person doing the surgery on the operating table was Huang Lao.

"Director Zhu, be careful not to pollute the surgery area." Huang Lao reminded a little unhappy.

Zhu Jun was stunned, suddenly ashamed.

The momentary loss of consciousness made him... almost make a big mistake.

"Old Huang, are the lymph nodes..." Zhu Jun hurriedly went back to make amends.

At this time, the lower pulmonary ligament and lymph nodes are freed first, and it is still the ninth group. Zhu Jun is a little anxious.

"It's okay." Huang Lao said lightly, "The lymph node cleaning can be completed within four to 10 minutes."

"..." Zhu Jun's eyeballs bulged out.

"The cooperation between the two is not bad. The lymph nodes can be cleaned as much as possible. It seems that it is possible to complete the operation normally."

"..." Zhu Jun's eyeballs almost fell out.

"Old Huang, time, time." Zhu Jun reminded in a low voice.

"I heard you said that there is still an hour and a half. I asked Deng Ming to prepare according to an hour. The time is about the same." Mr. Huang looked back at his watch, "It's only a few minutes since the power outage, and it's okay to clean 45 sets of lymph nodes within 4 minutes." question."

45 minutes...cut out the small lung nodules...cleaned 4 groups of lymph nodes...

Just kidding!

But Zhu Jun knew that this was not a joke. While he was talking to Mr. Huang, the ninth group of lymph nodes next to the lower pulmonary ligament had been cleaned, wrapped in gauze and taken out by Zhou Congwen.

The countdown in the upper right corner of Zhou Congwen's vision has changed to 36'22".

Every change in the numbers brings him tremendous pressure.

Surgery is not an Olympics, and even in the previous life when I was on the same stage with foreign surgeons, time was not the most important thing.

The operation must be done cleanly, and it is far from enough.

But this time was different. The countdown to the power outage was urging Zhou Congwen in the upper right corner of his vision like a ghost.

Adults, of course, don’t know how to do multiple-choice questions. Zhou Congwen chooses all of them. He not only needs to do a thorough lymph node dissection, but also completes it within the specified time.

The big heart was beating more and more slowly, not as fast as it was when he received emergency treatment, but the smell of adrenaline had already dissipated, but now Zhou Congwen was so engrossed that he didn't pay attention at all.

After cleaning 7 groups of lymph nodes, Zhou Congwen carefully dissected the lower pulmonary vein to avoid accidental injury.

25'56", the lymph nodes were removed.

At 22'01", the third group of lymph nodes was also cut and taken out.

After cleaning the three groups of lymph nodes, Zhou Congwen took out the long pliers and handed them to Deng Ming, who took over the thoracoscopic lens.

The two of them didn't have any verbal communication, and everything went smoothly as if they had cooperated with hundreds of operations.

Deng Ming looked at the screen and began to clean the 11th group of lymph nodes in the interlobar area.

The operation was performed... Zhu Jun was in a daze, as if it was no different from when Zhou Congwen performed the operation just now.

One-on-one, simple and clean.

Then, 2-4 groups of lymph nodes next to the trachea and blood vessels were cleaned.

I didn't see how rushed the operation was, all the lymph nodes that needed to be cleaned were cleaned, and before I knew it, the operation was about to end.

It took Deng Ming 10 minutes to dissect several groups of lymph nodes, and the numbers in the upper right corner of Zhou Congwen's field of vision became less and less, almost reaching single digits.

There are still 12 minutes until the end of the power supply.

"Warm salt water rinse."

Zhou Congwen stretched out his hand.

The warm salt water had been prepared long ago, and the water basin was handed over to Zhou Congwen.

He removed the thoracoscope lens and poured the water straight down.

The diameter of the stamp card is 2.2cm, which is smaller than a dollar coin.

Zhu Jun is careful every time he pours water to rinse, but no matter how careful he is, water will spill out.

So Zhu Jun went back to meditate for a long time, built a funnel by himself, and ordered the operating room to disinfect the funnel as a chest surgery equipment.

Zhu Jun is very proud of this. For surgery, many tricks depend on whether you put your mind to it or not.

What can a funnel do? It saves you from spreading water everywhere, and the sterile area is clean. It’s also comfortable to look at.

He just wanted to remind him, but Zhou Congwen poured water as soon as he raised his hand, the water flowed evenly and clearly, and entered the chest cavity along the poke card, without dripping.

A simple action seemed to explain all doubts to Zhu Jun.

Only familiar with hands.

"Prepare to wake up." Deng Ming reminded the director of the anesthesiology department.

"Oh, oh." The director of the anesthesiology department responded quickly.

He was also dumbfounded watching the operation. Can laparoscopic surgery be so awesome?It was simply unbelievable, completely beyond his understanding of surgeons.

If Mr. Huang cooperated with Director Deng of 912, he would be able to explain it, or even though he couldn't figure it out, the director of the anesthesiology department would also agree.

With the big hands of the imperial capital, the operation must be awesome.

But now the two standing on the operating table are Director Deng, and the other is... a junior doctor from the Third Hospital.

The third hospital, that is a hospital reformed by the health center. In the eyes of doctors in the people's hospital, the third hospital is a grassroots hospital.

Although he was inexplicably surprised, he didn't have time to think about it. The director of the anesthesiology department began to reduce the medicine to wake him up.

The number in the upper right corner of Zhou Congwen's field of vision has changed to single digits - 00:00:08:51.

After washing, no active bleeding was found, and the director of the anesthesiology department took a look at the patient's airway.

There is no saline flushed in the airway, which proves that the tracheal fistula has been tightly sealed.Withdraw the saline and begin to close the chest.

The number in the upper right corner of Zhou Congwen's vision continued to decrease, cold and ruthless, as if he was dismantling a time bomb.

00:00:07:32.

Zhu Jun didn't know that there was only so much time left, and he always thought that there was plenty of time.

He just sighed in the deepest part of his heart, paralyzed!Doesn't this remove the lymph nodes?Zhu Jun looked at Zhou Congwen who was busy on the operating table, full of doubts and puzzles.

"It's really a pity." Huang Lao bowed his waist slowly, returning to the appearance of an old man, "There are a few technical details for you to see. Time is running out, it is better for you young people to do it. I My hands are okay, but I'm afraid my heart won't be able to withstand this torture."

As he said that, Huang Lao shook his head regretfully, "I'm afraid of being young, it's good to be young."

"Boss, there will be a chance next time." Zhou Congwen turned his head and squinted his eyes, then covered it with gauze, held a knife in his right hand, and cut open the lymph nodes.

"The lymph nodes are fine, they are deformed by irritative edema." Zhou Congwen handed the lymph nodes on the gauze to Huang Lao.

"There is enough time, so be careful." Huang Lao nodded, turned around and sat on the chair in the corner of the operating room, and slowly closed his eyes.

Zhou Congwen also took a deep breath.

No wonder the requirements of the tasks given by the system are so low, and the names are all so LOW, called [just finish]. It turns out that there was an inexplicable twist in the middle of the power outage.

Power outage... Zhou Congwen sighed, feeling helpless.

When I was a child, there were frequent power outages in my hometown, but as time went by, the power supply was no longer tight, and I have never had a power outage for a long time in my memory.

The surgery was done beautifully. In the case of a power outage, I and the elder brother cooperated seamlessly and took it off cleanly.

This task is at least "S" level, Zhou Congwen evaluated in his heart.

00:00:06:22, the anesthetist inflated the lungs and found no air leak, the operation was perfect!

00:00:05:31, the flushing is over, the aspirator is washed with salt water, and the chest bottle is left.

00:00:03:21, Zhou Congwen and Deng Ming each held a corner needle and sewed the leather with No. [-] thread.

00:00:02:35, after closing the chest, the patient woke up almost at the same time.

As the chest closure was over and the patient regained consciousness, Zhou Congwen heard a crisp "ding dong".

surgery is over,

mission completed.

距离供电结束时间还有2分多钟，一直定格在00:00:02:14的数字上。

Only then did Zhou Congwen relax.

Even an old gun like him is the first time to complete the operation under someone's urging, what the hell!Such a weird thing happened.

After a few seconds, the color of the system panel returns to normal.

To Zhou Congwen's surprise, an "S"-level task was completed, and instead of making the system panel clearer, the dense fog above it seemed to be thicker.

Zhou Congwen stared blankly at the system panel, thoughtful.

Chapter 0272 Why not clean the lymph nodes

"Director Zhu, come here." Mr. Huang greeted Zhu Jun while sitting on a chair in the corner.

"Hey, Mr. Huang, what advice do you have?" Zhu Jun walked over obediently with his head down.

"I don't dare to advise you. There are some academic differences. Let's discuss it." Huang Lao said lightly, "I heard you said that the third hospital invited a professor to perform surgery, only wedge cutting, and didn't clean up the lymph nodes. I thought you thought it was wrong. .”

Zhu Jun was taken aback. At that time, Mr. Huang didn't say anything, so why did he tell himself now.

"It's okay, there is no right or wrong in academic discussions, it's just for the benefit of patients." Huang Lao said lightly, "Doctor Zhou."

"boss."

"Tell me why you didn't remove the lymph nodes when you performed wedge resection for small nodules."

"The NCCN guidelines recommend N1 and N2 lymphadenectomy for patients undergoing lung cancer surgery.

However, whether extensive pathological lymph node dissection and evaluation is necessary for patients with small tumors, especially early-stage lung cancer, compared with patients with larger tumor volumes is still controversial. "

Zhou Congwen replied while arranging the used items on the operating table.

Zhu Jun listened in a daze.

The tone of the junior doctor in the Third Hospital didn't sound like a junior doctor, but rather like Huang Lao was using the most authoritative tone to describe the latest research results in the academic world.

"Tumors are different in size. Recently, there has been a relatively clear statement about whether to dissect the lymph nodes."

"Professor Gulack from the Duke Medical Center in the United States and others conducted a study. The researchers used the National Cancer Database to evaluate the relationship between tumor size and the optimal range of lymph node resection. The results of the study were published in the journal Lung Cancer."

"The correlation between the number of lymph nodes resected and the prognosis of patients with clinical stage I lung cancer who underwent lobectomy between 1998 and 2001 was analyzed using a Cox proportional hazards model.

At the same time, according to the tumor size, the patients were divided into two groups of ≥2cm and less than 2cm, and three groups of about 0.5cm for comparison. "

“共13，827例肺癌患者纳入研究，平均每例患者淋巴结切除中位数为7，范围为4-11。研究者通过生存分析发现当淋巴结切除的数量为11个时史患者的生存明显获益。”

"Removal of 2 lymph nodes in patients with tumors smaller than 4 cm can significantly benefit the survival of patients. Removal of 2 lymph nodes in patients with tumors ≥ 11 cm can also significantly benefit the survival of patients."

"There is no statistical error between lymph node dissection and no lymph node dissection in patients with small pulmonary nodules."

"So for patients with small pulmonary nodules of 0.5-1cm, the simple consensus of the world's thoracic surgery community is that no lymph node dissection is required."

Zhou Congwen lifted the sterile sheet, pasted the incision on the patient's chest wall with sterile gauze, and then the nurse handed it over... Dabai.

Big white tape!

Zhou Congwen's eloquent tone was stagnant.

The inexplicable ease of cooperating with the big brother made Zhou Congwen return to his previous life in a trance.At least in his consciousness, it is about sticking, how could there be such a creature as a big white tape!

Wearing sterile gloves and tearing off the large white tape, the tape will stick to the glove, which is very annoying.

There is no way, who let it be 2002, let's spread our hands and look at the sky.

Zhou Congwen no longer explained why he didn't do lymph node dissection, but began to tear off the large white tape in frustration.

Huang Lao looked at Zhou Congwen's back appreciatively, with joy in the corners of his eyes and brows.

"Director Zhu, do you understand?" Elder Huang asked calmly, "Doctor Xiao Zhou didn't finish what he said. Mayo still has a larger sample, but this is enough."

"..." Zhu Jun listened and thought about it, but he didn't agree at all.