My medical path
Chapter 165 Multidisciplinary Consultation
Chapter 165 Multidisciplinary Consultation
When Chen Bo followed Director Lu to the conference room, representatives from other departments had already arrived.
In addition to the usual meetings held in this conference room, multidisciplinary consultations are also basically arranged here.
Because it can be connected to the hospital's medical records and imaging systems, patients' information can be accessed at any time.
Multidisciplinary consultation on tumors is applied by the patient department, presided over by the medical department, and participated by relevant departments.
Today, in addition to the trauma and hand surgery represented by Director Lu, there are general surgery, oncology, pathology and radiology.
Not many departments participated, and they were all departments directly related to this operation.
Seeing that everyone was present, the representative of the medical department in charge of the consultation briefly greeted the directors of each department, and then asked the doctor in charge of the ENT department to report the medical history.
Chen Bo listened carefully to the report of the doctor in charge.
The medical history was uncomplicated, and the patient was admitted for aphonia and dyspnea.
Fiberoptic laryngoscopy has been done, and the pathology was taken, and the pathological diagnosis was squamous cell carcinoma.
With the pathological diagnosis, the next thing we want to discuss is the treatment plan.
After the doctor in charge reported the medical history, the director of the ENT department made a brief summary:
"The patient has lost his voice and has obvious dyspnea. The tumor is located in the glottis area. The pathology suggests squamous cell carcinoma. No regional lymph nodes or distant metastasis were found in the preoperative examination. Now he has undergone preoperative radiotherapy. Please come here today, it is a comprehensive Assess the condition and determine the surgical plan..."
After listening to the narration of the director of the ENT department, the director of the Radiology Department affirmed what Director Zhang said:
"It is indeed as Director Zhang said, if we look at the film here, the tumor is indeed located in the glottis, and there is no evidence of regional lymph nodes or distant metastasis..."
The director of the Radiology Department introduced the images to everyone while reviewing the images.
The director of the pathology department also explained the pathological results:
"Laryngoscopy took four parts of the pathology, and tumor cells were found in three of them, which belonged to moderately differentiated squamous cell carcinoma..."
"Let me also tell you about our situation..."
Just after the director of the pathology department finished speaking, the director of the oncology department went on to say:
"This patient has already undergone radiotherapy in our department. From the perspective of the effect of radiotherapy, the tumor has shrunk. Now the tumor is relatively limited. It is time for surgery. After surgery, radiotherapy can be done again to reduce the probability of recurrence. ..."
After the director of the oncology department finished speaking, everyone present except Chen Bo did not know each other, and only the director of the general surgery department and director Lu did not speak.
The director of the general surgery department had a general understanding of the meaning of asking for a consultation from the ENT department before coming here.
Like Director Lu and his department, it's all about the choice of surgical method.
From Director Zhang Daming's plan, he actually prefers to take the jejunum to reconstruct the throat.
Because histologically, intestinal tissue heals more readily than extremities.
Moreover, general surgery has a better understanding of the anatomical structure of the anterior neck than orthopedics.
Because the operation area is close to the thyroid gland, it is a common operation site in general surgery, and it can complement their otolaryngology department during the operation.
In particular, although the tumor has not seen any nearby invasion from the imaging studies, it is not allowed to invade the thyroid gland if it continues. With the presence of general surgery, it is more guaranteed.
And they have already had similar cooperation with general surgery before, and the effect is not bad, but they invited professors from other schools to do it, and they brought their own micro suture experts, so they didn't need Director Lu's help.
"Director Zhang, if you decide to use the jejunum as the transplant material, just discuss it with the patient. It is very simple for us to obtain materials...Of course, the risks must be clearly explained to the patient, mainly intestinal adhesions, intestinal obstruction, and intestinal fistula. These problems may still arise..."
The director of general surgery said.
"Thank you, Director Zou, with your backing, we can feel much more at ease when we carry out the operation..."
Director Zhang Daming of the Department of Otorhinolaryngology expressed his gratitude.
At this moment, Director Lu's phone on the table vibrated. Seeing that it was the dean calling, he got up and gestured to Director Zhang to answer the phone, then got up and walked out.
Here, the director of general surgery has finished speaking, and the only one left on the scene, Director Lu, did not express his opinion.
After Director Lu walked out, Chen Bo, who was sitting next to Director Lu just now, stood out.
When several directors expressed their opinions just now, Chen Bo kept listening, so his sense of presence was very low.
Chen Bo knows that this kind of multidisciplinary consultation is actually a process in most cases and sharing risks.
The plan is basically determined before the consultation. The purpose of the consultation is to find out the gaps and make up for the omissions, and then get some different ideas from the perspective of different specialties.
...........................
Director Lu's phone call was a bit long. It had been 10 minutes and he hadn't come back yet. Several directors on the scene were getting impatient.
The representative of the medical department is also very helpless, he is just an officer of the medical department, and his rank is not a bit worse than these clinical bosses.
At this moment, he could already see that the big bosses were a little impatient, and he was really anxious.
Then he saw Chen Bo who was sitting calmly, his eyes lit up, and he asked:
"This comrade, is he from the Surgeon Department? Director Lu hasn't come back yet, why don't you say a few words first?"
As soon as the representative of the medical department spoke, everyone's eyes were on Chen Bo.
To them, it didn't matter whether Chen Bo was the director or not. Since Director Lu brought him to the meeting, they naturally recognized him.
As long as Chen Bo's opinion is reliable and can represent the opinion of Trauma Hand Surgery.
Seeing everyone's eyes, and then looking in Director Lu's direction, Chen Bo felt a little helpless.
It seems that it is difficult to be a small follower quietly.
"Teachers are in a hurry, let me say a few words first..." Chen Bo sat upright, looked around the crowd, and said:
"First of all, thank you directors for giving me this opportunity..."
"For this kind of patients, in fact, the predecessors have already opened a good way for us, and basically searched all the parts that can be thought of... They are all doing the work of tearing down the east wall to make up the west wall..."
Chen Bo paused, and continued:
"Currently, the jejunum from the general surgery side and the leather tube from our side are actually very good materials. The main choice is still for the patient to see which part of the function he can accept to lose..."
Chen Bo finally emphasized:
"Technically speaking, it's not very difficult, but the choice of the specific plan is up to you, Director Zhang, to make up your mind..."
As soon as Chen Bo said this, several directors couldn't sit still and looked at him one after another.
If these words come from Director Lu, everyone will only think that Director Lu is confident...
But when Chen Bo said it, it was a bit awkward.
Because Chen Bo still looks too young, and the impression of several major directors is that there is not such a young deputy director of the Department of Traumatology and Hand Surgery...
The young man in front of him is also an ordinary doctor.
In the eyes of so many bigwigs, it is impossible to get into the eyes of the law...
But Chen Bocai doesn't care what everyone thinks, since he has spoken, of course he has to make his point clearly:
"However, although both options are feasible, if the jejunum is removed, laparotomy is required, which will have too much impact... Although our option requires sacrificing an artery in the hand, it does not affect the function in most cases, so I think it is more Preferences..."
Chen Bo directly expressed his point of view.
After Chen Bo finished speaking, there was another low cry.
This is the rhythm of the public arena...
The next chapter is estimated at eleven o'clock
(End of this chapter)
When Chen Bo followed Director Lu to the conference room, representatives from other departments had already arrived.
In addition to the usual meetings held in this conference room, multidisciplinary consultations are also basically arranged here.
Because it can be connected to the hospital's medical records and imaging systems, patients' information can be accessed at any time.
Multidisciplinary consultation on tumors is applied by the patient department, presided over by the medical department, and participated by relevant departments.
Today, in addition to the trauma and hand surgery represented by Director Lu, there are general surgery, oncology, pathology and radiology.
Not many departments participated, and they were all departments directly related to this operation.
Seeing that everyone was present, the representative of the medical department in charge of the consultation briefly greeted the directors of each department, and then asked the doctor in charge of the ENT department to report the medical history.
Chen Bo listened carefully to the report of the doctor in charge.
The medical history was uncomplicated, and the patient was admitted for aphonia and dyspnea.
Fiberoptic laryngoscopy has been done, and the pathology was taken, and the pathological diagnosis was squamous cell carcinoma.
With the pathological diagnosis, the next thing we want to discuss is the treatment plan.
After the doctor in charge reported the medical history, the director of the ENT department made a brief summary:
"The patient has lost his voice and has obvious dyspnea. The tumor is located in the glottis area. The pathology suggests squamous cell carcinoma. No regional lymph nodes or distant metastasis were found in the preoperative examination. Now he has undergone preoperative radiotherapy. Please come here today, it is a comprehensive Assess the condition and determine the surgical plan..."
After listening to the narration of the director of the ENT department, the director of the Radiology Department affirmed what Director Zhang said:
"It is indeed as Director Zhang said, if we look at the film here, the tumor is indeed located in the glottis, and there is no evidence of regional lymph nodes or distant metastasis..."
The director of the Radiology Department introduced the images to everyone while reviewing the images.
The director of the pathology department also explained the pathological results:
"Laryngoscopy took four parts of the pathology, and tumor cells were found in three of them, which belonged to moderately differentiated squamous cell carcinoma..."
"Let me also tell you about our situation..."
Just after the director of the pathology department finished speaking, the director of the oncology department went on to say:
"This patient has already undergone radiotherapy in our department. From the perspective of the effect of radiotherapy, the tumor has shrunk. Now the tumor is relatively limited. It is time for surgery. After surgery, radiotherapy can be done again to reduce the probability of recurrence. ..."
After the director of the oncology department finished speaking, everyone present except Chen Bo did not know each other, and only the director of the general surgery department and director Lu did not speak.
The director of the general surgery department had a general understanding of the meaning of asking for a consultation from the ENT department before coming here.
Like Director Lu and his department, it's all about the choice of surgical method.
From Director Zhang Daming's plan, he actually prefers to take the jejunum to reconstruct the throat.
Because histologically, intestinal tissue heals more readily than extremities.
Moreover, general surgery has a better understanding of the anatomical structure of the anterior neck than orthopedics.
Because the operation area is close to the thyroid gland, it is a common operation site in general surgery, and it can complement their otolaryngology department during the operation.
In particular, although the tumor has not seen any nearby invasion from the imaging studies, it is not allowed to invade the thyroid gland if it continues. With the presence of general surgery, it is more guaranteed.
And they have already had similar cooperation with general surgery before, and the effect is not bad, but they invited professors from other schools to do it, and they brought their own micro suture experts, so they didn't need Director Lu's help.
"Director Zhang, if you decide to use the jejunum as the transplant material, just discuss it with the patient. It is very simple for us to obtain materials...Of course, the risks must be clearly explained to the patient, mainly intestinal adhesions, intestinal obstruction, and intestinal fistula. These problems may still arise..."
The director of general surgery said.
"Thank you, Director Zou, with your backing, we can feel much more at ease when we carry out the operation..."
Director Zhang Daming of the Department of Otorhinolaryngology expressed his gratitude.
At this moment, Director Lu's phone on the table vibrated. Seeing that it was the dean calling, he got up and gestured to Director Zhang to answer the phone, then got up and walked out.
Here, the director of general surgery has finished speaking, and the only one left on the scene, Director Lu, did not express his opinion.
After Director Lu walked out, Chen Bo, who was sitting next to Director Lu just now, stood out.
When several directors expressed their opinions just now, Chen Bo kept listening, so his sense of presence was very low.
Chen Bo knows that this kind of multidisciplinary consultation is actually a process in most cases and sharing risks.
The plan is basically determined before the consultation. The purpose of the consultation is to find out the gaps and make up for the omissions, and then get some different ideas from the perspective of different specialties.
...........................
Director Lu's phone call was a bit long. It had been 10 minutes and he hadn't come back yet. Several directors on the scene were getting impatient.
The representative of the medical department is also very helpless, he is just an officer of the medical department, and his rank is not a bit worse than these clinical bosses.
At this moment, he could already see that the big bosses were a little impatient, and he was really anxious.
Then he saw Chen Bo who was sitting calmly, his eyes lit up, and he asked:
"This comrade, is he from the Surgeon Department? Director Lu hasn't come back yet, why don't you say a few words first?"
As soon as the representative of the medical department spoke, everyone's eyes were on Chen Bo.
To them, it didn't matter whether Chen Bo was the director or not. Since Director Lu brought him to the meeting, they naturally recognized him.
As long as Chen Bo's opinion is reliable and can represent the opinion of Trauma Hand Surgery.
Seeing everyone's eyes, and then looking in Director Lu's direction, Chen Bo felt a little helpless.
It seems that it is difficult to be a small follower quietly.
"Teachers are in a hurry, let me say a few words first..." Chen Bo sat upright, looked around the crowd, and said:
"First of all, thank you directors for giving me this opportunity..."
"For this kind of patients, in fact, the predecessors have already opened a good way for us, and basically searched all the parts that can be thought of... They are all doing the work of tearing down the east wall to make up the west wall..."
Chen Bo paused, and continued:
"Currently, the jejunum from the general surgery side and the leather tube from our side are actually very good materials. The main choice is still for the patient to see which part of the function he can accept to lose..."
Chen Bo finally emphasized:
"Technically speaking, it's not very difficult, but the choice of the specific plan is up to you, Director Zhang, to make up your mind..."
As soon as Chen Bo said this, several directors couldn't sit still and looked at him one after another.
If these words come from Director Lu, everyone will only think that Director Lu is confident...
But when Chen Bo said it, it was a bit awkward.
Because Chen Bo still looks too young, and the impression of several major directors is that there is not such a young deputy director of the Department of Traumatology and Hand Surgery...
The young man in front of him is also an ordinary doctor.
In the eyes of so many bigwigs, it is impossible to get into the eyes of the law...
But Chen Bocai doesn't care what everyone thinks, since he has spoken, of course he has to make his point clearly:
"However, although both options are feasible, if the jejunum is removed, laparotomy is required, which will have too much impact... Although our option requires sacrificing an artery in the hand, it does not affect the function in most cases, so I think it is more Preferences..."
Chen Bo directly expressed his point of view.
After Chen Bo finished speaking, there was another low cry.
This is the rhythm of the public arena...
The next chapter is estimated at eleven o'clock
(End of this chapter)
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