Start From Emergency Doctor
Chapter 53
Chapter 53
He Jian sighed and shook his head.
Zhou Yuan remembered his ununlocked total gastrectomy.
“Teacher, maybe you can try total gastrectomy.” Zhou Yuan said.
“No. It has reached the advanced stage of gastric cancer, and the nearby organs have also been invaded by gastric cancer. There is no point in doing total gastrectomy.”
He Jianyi frowned: “Furthermore, total gastrectomy is a four-level operation, which is extremely difficult in itself, and only senior chief physicians dare to do it.”
“Ultrasound shows that only part of the nearby organs is affected. We can remove the affected organs together.” Zhou Yuan handed over the ultrasound image of the abdomen.
Before the two of them had finished their discussion, Yang Wei’s wife folded her hands in an X shape, “No way! Without the stomach, what will my husband eat in the future! That is not just dead!”
Zhou Yuan explained helplessly.
“The function of the stomach is indeed very important, but it is of little significance to your husband. In fact, the stomach only provides the mechanical function of temporarily holding and grinding food, and there is also a negligible part of the digestion and absorption function.”
This is a misunderstanding of many people about total gastrectomy.
Zhou Yuan said: “The digestion of food mainly depends on the small intestine. Even after a total gastrectomy, there will still be a sense of hunger, and the digestive function of the intestine will not be affected. After a total gastrectomy, there are many ways to reconstruct digestion. Tao.”
“Can you… keep a little bit?” Yang Wei’s wife asked cautiously.
Zhou Yuan shook his head helplessly: “We can only consider the long-term effect. Your husband discovered gastric cancer too late, and now we can only consider total gastrectomy.”
“What will happen to my husband…” Yang Wei’s wife wiped her tears.
Zhou Yuan hesitated for a moment, but chose to tell the truth.
“Patients with advanced gastric cancer will have a significant decline in their quality of life. Afterwards, hematemesis and melena may appear, accompanied by symptoms such as anemia and weakness of the limbs.”
“I had sent him to the hospital for a long time! I wrote that novel every day, and when he vomited blood, I said that I would update it! Uuuuu…” Yang Wei’s wife sobbed.
“Apart from these? What else?” Yang Wei’s wife planned to accept all the blows at once.(Read more @ wuxiax.com)
“Otherwise, persistent upper abdominal pain. Later, swelling, pain and edema appear. At the end, symptoms such as loss of appetite, nausea and vomiting, and difficulty swallowing will occur.”
Of course, Zhou Yuan still has something to say.
In the advanced stage of gastric cancer, the cancer cells will spread directly to the neighboring pancreas, liver, and transverse colon nodes, as well as to the lymph nodes around the stomach and distant lymph nodes via the lymph. This can be judged by touching the hard and inactive lymph nodes on the left supraclavicular .
In addition, cancer cells can also be transferred to liver metastases, brain, bones, ovaries, etc. through blood circulation, resulting in ascites, jaundice, hepatic ascites, and ascites.
The enlargement of the cancer itself can also cause complications such as gastric perforation, bleeding, necrosis, and obstruction.
In any case, Yang Wei’s life has basically come to an end in the advanced stage of gastric cancer.
A total gastrectomy is just to extend life and improve the quality of life in the final stage.
Zhou Yuan said again: “The five-year survival rate after total gastrectomy is about 20%, or you can choose chemotherapy to delay tumor recurrence and control tumor progression, but given your husband’s current situation, chemotherapy is of little significance. If you don’t perform a total gastrectomy, I’m afraid it won’t last long.”
“I see. Can I discuss it with my husband?” Yang Wei’s wife lowered her head.
The door to the ward closed again, Zhou Yuan caught a glimpse of Yang Wei sitting up reluctantly, and making a face with himself.
“Teacher, what is your decision?” Zhou Yuan asked.
“There is a director of the Gastroenterology Department who is good at total gastrectomy, but he was asked to go to the province to perform an operation on a cadre.” He Jianyi was a little embarrassed.
In the hospitals, interns are subsidized by a few hundred dollars a month, and some hospitals that are short of it require the interns to post money back. Resident doctors only cost two to three thousand yuan, and those with a higher seniority have several thousand.
Experts like this kind flying around the country can get a salary of 10,000 to 20,000 yuan for a single outing for a consultation. The gap is huge.
Zhou Yuan looked at his three intermediate treasure chests and said, “Teacher, maybe I can.”
He Jian’s desire to be a helper ignited in his eyes, “You can?!”
He didn’t understand.
Can a total gastrectomy be done, but not a gastroscopy? !
“You kid won’t let me practice gastroscopy, want to see my level!” He Jianyi was immediately happy and guessed.
Zhou Yuan smiled: “You are my teacher, how dare I!”
“Can you really complete a total gastrectomy?” After a few smiles, He Jianyi became serious.
Seeing Zhou Yuan nodding, He Jianyi nodded too.
He Jian had seen too many miracles on this disciple, and he was a little numb now.
“Okay, call the ocean here.” He Jianyi said quickly.
It’s time for He Jian’s echelon doctors to study again.
After the completion of the preoperative inspection, Yang Wei’s body is completely ready for total gastrectomy.
Zhou Yuan also quietly opened the system panel.
Three intermediate treasure chests disappeared, and a brand new icon lit up.
“Obtained! Master total gastrectomy!”
————
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