Oncology Physician Life

Chapter 71 Chapter 70 Changes
Lu Jiajia didn't need to continue following Jiang Li for follow-up visits, and planned to go to the Cardiac Surgery Department to observe heart removal and transplantation after lunch in the hospital cafeteria.

There are two canteens in the Cancer Hospital, one is in the inpatient building and the other is the staff canteen. For the convenience of doctors, it is specially set up in the tumor building, so you don’t have to go far.

When Lu Jiajia rushed to the cafeteria, there was already a long queue in front of the food counter. She stood on tiptoe and looked around, never expecting that the cafeteria would be so crowded today.

Zhang Linlin came over from behind with a plate, and smiled softly at her: "Today's lunch includes dry-cooked chicken, croquettes, roasted chicken legs, and sweet and sour pork ribs, so there are a lot more people than usual."

Lu Jiajia pursed her mouth: "I'm so worried. Today I deliberately came a few minutes earlier, but it turned out to be late. When I arrive, there will be no fried chicken legs, right?"

"By the way, isn't the Department of Cardiac Surgery going to cooperate with the Department of Pediatric Oncology this afternoon?" Zhang Linlin asked curiously, "I heard that it is a very rare patient with heart tumors. I have been working for so many years, and this is the first time I have seen a patient with a heart tumor." , there should be a lot of people watching this afternoon, right?"

Lu Jiajia counted with her fingers: "There should be a lot of people in the Department of Cardiology, Cardiology, and Oncology, but I'm curious, why should the Department of Thoracic Surgery join in the fun?"

The two of them moved forward with the crowd while talking, and when Lu Jiajia came to the dining table with a plate, there was just one fried chicken leg left, which was put on the plate of the man in front by the aunt who was ordering food from the cafeteria.

"NO, no, my chicken legs!"

Lu Jiajia stared at the fried chicken legs and moved, and his eyes fell on Shu Yusheng's tall and straight figure.

Shu Yusheng glanced at the fried chicken legs on his dinner plate, then looked at Lu Jiajia's eager eyes, and asked, "Do you want to eat?"

Lu Jiajia nodded like a chicken chasing rice: "Doctor Shu, can you take this chicken leg..."

Before Lu Jiajia could finish speaking, Shu Yusheng firmly refused, "No, first come, first served!"

Lu Jiajia puffed up her cheeks, stared fiercely at Shu Yusheng's arrogant back, and snorted coldly: "It's amazing to be back from Hokkaido! You're a cheapskate!"

Zhang Linlin followed her, looked at the gloomy expression on her face, and joked: "It's amazing to come back from Hokkaido, don't you know, Shu Yusheng has already been appointed internally, and he will stay directly after the internship and become a resident doctor." .”

"Official appointment?!" Lu Jiajia was startled, "Didn't it mean that the number of regular appointments in the oncology department is limited, and the competition is fierce. How can I still make an internal appointment?"

Zhang Linlin shrugged her shoulders: "I can't help it, who made him so good, Liu Chong, the chief director of the oncology department, personally talked to him, and the directors of our department are afraid of dissolving this kind of talent in their mouths. Holding it in the palm of your hand is afraid of falling, talent is scarce!"

Lu Jiajia walked in with a plate, the cafeteria was almost full, Zhang Linlin saw an empty seat and sat down first.

Lu Jiajia looked around, but there were no vacant seats around. As he was walking inside, he saw an empty table next to the pillar, and there was only a boy sitting there with his back facing him.

She ran over happily and hurriedly, sat down, lowered her head and was about to start eating, when the tall figure on the opposite side enveloped her.

"Lu Jiajia?!"

With a meatball stuffed in Lu Jiajia's mouth, she heard the male doctor calling her, and when she looked up, she saw Shu Yusheng's expressionless face, sitting right across from her, so scared that she almost choked on the meatball in her mouth. He said indistinctly: "Why...how is it you! What a coincidence!"

"Unfortunately, this is the seat I took for Senior Brother Xu and Senior Brother Tan."

Lu Jiajia put the rice into his mouth tightly: "Then I will eat it quickly, and I will definitely not delay their meal!"

"I heard that your Children's Oncology Department and Cardiac Surgery Department have a joint operation this afternoon?"

Shu Yusheng put down the SCI in his hand, looked up at Lu Jiajia on the opposite side, and opened his mouth to talk about the patient's condition.

"The patient was only 14 years old. He had an operation half a year ago because of a tumor growing in the heart. Half a year after the tumor was removed, three tumors grew in the left atrium of the heart. The cause was unknown. The tricuspid valve was almost completely blocked, and the degree of tumor adhesion was too high. It was too high to be surgically removed, so it was decided to remove the whole heart and replace the heart to remove the tumor.”

Lu Jiajia looked at him in surprise: "How do you know so well?"

Shu Yusheng leaned forward slightly, his narrow eyes fixed on Lu Jiajia's surprised face.

"I heard that Professor Jiang will give the patient cardioplegia in advance, so that the heart and lungs of the patient will stop working, and then use the extracorporeal circulation mechanism to build an artificial channel to replace the heart and lung function, and then perform the heart transplant operation!"

"How do you even know the operation plan so well?"

The shock on Lu Jiajia's face continued to expand, "Aren't you from the oncology department? Why are you so concerned about our children's oncology operations?"

Shu Yusheng didn't answer her question, and continued to ask: "However, I heard that the donor's heart is a quarter larger than the patient's heart, which adds a lot of difficulty to the heart anastomosis. There are at least two arteries connected to the heart. The blood vessels need to be sutured, and then the heart and lungs must be rejuvenated at the specified time, I am afraid it is not a small challenge, right?"

"Ms. Jiang is helping the unexpected Professor Dong Tianshu. Most of the surgery should be done by Professor Dong." Lu Jiajia put down his chopsticks.

Shu Yusheng raised his eyebrows: "Professor Dong is 53 years old this year, so I'm afraid he won't be able to do such a high-intensity operation. In the end, Professor Jiang should be the one to do the stitching."

Lu Jiajia looked at him slyly: "Could it be that you have some unknown purpose?"

Shu Yusheng looked at the fried chicken legs on the dinner plate, a slight smile appeared on the corner of his lips, and he quickly covered it up: "Every department has a quota for observation, but you and Yang Xiaolan are the only two interns in your Children's Oncology Department. so……"

Lu Jiajia snorted coldly, stuffed a mouthful of balls into his mouth, and bit down hard: "Do you want me to take you into the observation room? That's no way!"

"Don't be so absolute!"

Shu Yusheng pushed the dinner plate forward calmly, and the corners of his mouth slightly raised again: "If you can agree to let me take a spot in your department to observe, I will invite you to take this chicken leg!"

Lu Jiajia looked back and forth between the golden and crispy fried chicken legs and Shu Yusheng, and hesitated for a moment: "Plus a week's lunch?"

"make a deal!"

Shu Yusheng readily agreed.

Lu Jiajia hurriedly said: "You are not allowed to cheat!"

Shu Yusheng stretched out his palm: "A word from a gentleman!"

Lu Jiajia raised his hand, and patted it up: "It's hard to catch a four-horse!"

Shu Yusheng pushed the dinner plate in front of her: "The chicken leg is yours!"

Lu Jiajia happily picked up the fried chicken leg, took a bite with satisfaction, and suddenly looked at Shu Yusheng and didn't find it so annoying. In her eyes, this was a meal ticket for walking. If she had known that the other party was inhuman, she should have asked for it. Free lunch for half a month.

Seeing Lu Jiajia's foodie appearance, Shu Yusheng felt extremely proud.

For the rare patient with a tumor in the heart, the Department of Cardiac Surgery may not meet one case in a year. The opportunity to observe is rare, and each department basically has no quota.

The competition in oncology surgery is already fierce. For this level of surgery, he can only watch the video of the surgery afterwards. It is absolutely impossible for him to broadcast the live broadcast, and the second-line doctors will divide it up.

But the children's oncology department is small, with only two interns, and he got this hard-won opportunity with just one week's lunch, which is a huge profit!
Besides, the other party is a girl, if she can eat a meal, how much can she eat?

In the afternoon, an OA notification popped up in the doctor's office. The joint operation of Cardiac Surgery and Children's Oncology Department was in operating room No. 8. The doctor who was about to observe immediately ran towards the operating room, rushing to grab a favorable position.

Lu Jiajia was sitting in the office peeling apples. She carefully pressed the fruit knife in her hand along the skin of the apples. A series of peels slid off the blade without any interruption.

Just when she was about to finish, Shu Yusheng hurried in, took her hand and walked out.

The apple peel in Lu Jiajia's hand also broke in two.

"Hey, hey, what are you doing! So anxious!"

Lu Jiajia looked up and gave him a hard look, "Look, you broke my apple skin!"

Shu Yusheng looked very anxious, afraid that if he went late, he would not have a good seat in the observation room.

He frowned, seeing that two peels were broken in Lu Jiajia's hand, he couldn't help laughing angrily: "Is the peel important now, or the operation?"

Lu Jiajia angrily put down the apple: "Surgery, Mr. Jiang hasn't gone to the operating room yet, why are you in a hurry! It's not you who performed the surgery!"

"Lu Jiajia, I have never seen such a hopeless intern like you!"

Shu Yusheng shook his head and sneered, "Then do you still want to have a free lunch for a week?"

Lu Jiajia looked at him vigilantly: "Do you want to go back on your word?"

Shu Yusheng patted his forehead, feeling that the other party was really hopeless, and his mind was full of food.

He walked away first without looking back.

"If you want to, immediately follow me to the observation room!"

Hearing what he said, Lu Jiajia hurriedly picked up the notebook, followed Shu Yusheng's buttocks, and walked towards the observation room. Before leaving, she still did not forget to raise her head and stare at Shu Yusheng fiercely.

The observation room is next to operating room No. 8. It is not only spacious, but also fully equipped, including the most advanced Da Vinci hand robot.

When Lu Jiajia rushed over with Shu Yusheng, the observation room was already full of white coats on the inner and outer third floors, including many second-line doctors in the Department of Cardiology, Cardiology, Oncology, and Thoracic Surgery, all waiting for this rare case. Cardiac tumor surgery.

Originally, a joint operation was not enough to attract so many doctors to watch, but this one is really too rare.

The heart is a special human organ, and the chance of developing a tumor is almost one in [-]. The hospital's cardiac surgery department does not see a single case in a year.

What's more, this operation is a rare heart replacement and tumor removal operation, which requires the complete resection of the heart with the tumor and simultaneous heart transplantation.

Even if an extracorporeal circulation channel is built, it can replace the heart and lung function of the human body in a short period of time, but only for a short period of time, which means that the surgeon must complete the heart transplant operation within the specified time and ensure the heart and lung rejuvenation. Otherwise, the patient may not be able to get off the operating table.

It also means that the possibility of heart transplant failure will be very high.

The 14-year-old Chunchun had received preoperative anesthesia in advance, and she was lying motionless on the operating table.

In the spacious operating room, the anesthesiologist took the cardioplegia solution from the nurse and prepared to inject it.

He glanced at the nurse who was already standing in front of the extracorporeal circulation machine. Once the injection of cardioplegia solution is completed here, the extracorporeal circulation machine will be turned on to replace the patient's cardiopulmonary work.

In this way, the chief surgeon can stop the heart, cut off the heart, and then suture the donor heart in a bloodless environment, then shut down the extracorporeal circulation machine, wait for the donor heart to re-beat, and restore heart function .

The door of the operating room was also slowly opened at this time, and Jiang Li and Professor Dong Tianshu walked in one by one.

The itinerant nurse immediately wrapped the two in surgical gowns and put on rubber gloves.

Jiang Li glanced at Professor Dong Tianshu, with a serious face: "The donor has arrived, and Professor Dong will perform the heart resection here, and I will leave the subsequent suture and resuscitation to me."

Professor Dong Tianshu nodded: "Just follow the operation plan we simulated in advance!"

Jiang Li nodded, and came to the position of the first assistant in front of the operating table. She looked at the status of the physical signs displayed on the monitor screen.

At this time, the cardioplegia solution had been injected, and on the pure cardiac monitoring instrument, the wavy line representing the beating of the heart rhythm immediately changed its shape, and the moment the heart muscle stopped beating, the electrical activity of the heart completely became a straight line.

When the operation was about to begin, Jiang Li nodded to the nurse in front of the cardiopulmonary bypass machine.

The nurse immediately started the extracorporeal circulation machine.

This is a precision medical instrument composed of a group of pumps, which can drive blood to flow in a predetermined direction and speed, replace the function of the patient's heart to pump blood, and also drive cardioplegia to attract blood from the heart chamber and the surgical field.

Professor Dong Tianshu saw that the extracorporeal circulation machine was running, and the blood in Chunchun's heart began to pass through the artificial channel and flow into the machine. He immediately took the scalpel to open the chest and cut the heart.

Jiang Li was always watching the progress of Professor Dong Tianshu's heart cutting, and at the same time, he did not take his eyes off the heart donor that had been prepared long ago.

"Scalpel."

"Stop the bleeding. Suction."

"Vascular clamp."

In the operating room, Professor Dong Tianshu has been holding the scalpel for more than an hour.

Lying on the operating table, Chunchun, a 14-year-old girl, fell into a deep sleep due to severe general anesthesia, and her face was extremely pale.

Finally, with the sound of nailing the instrument, Professor Dong Tianshu took out a completely cut heart from the girl's chest with his hands in white rubber gloves, and placed it on the stainless steel tray that the nurse had prepared long ago.

Jiang Li immediately switched to the position of Professor Dong Tianshu. Through the Kepler magnifying glass, she stared at the severed pulmonary artery and aorta, concentrating all her mind.

Her voice sounded tired but powerful: "Prepare for donor heart transplant!"

"Give me the 4-0 Prolene line!"

Jiang Li stretched out his hands and put the one-size-larger donor heart into Chunchun's chest cavity. At the same time, he stretched out his index finger and freed it to the aorta connected to the heart.

He took the suture needle in the nurse's hand with his left hand, and gave instructions to the second assistant on the opposite side.

"All the aortic tubes should be ligated, and the aorta should be anastomosed end-to-end using double-caval anastomosis."

After speaking, Jiang Li stared intently at the suture thread in his hand, and quickly shuttled between the aortas with the hand holding the looper needle.

As time passed, her slender eyelashes were covered with sweat.

"The aorta is sutured, ready to suture the pulmonary artery!"

"4-0 Prolene Line!"

"shear!"

"Hemostatic forceps!"

"The continuous ends match!"

"shear!"

As the second assistant doctor in the Department of Cardiac Surgery, he didn't dare to breathe, watching the movements of Jiang Li's hands, the sutures coming in and out back and forth.

The time and difficulty of this operation far exceeded everyone's expectations. It was not until four o'clock in the afternoon that the suturing of the donor's heart was barely finished.

"shear!"

"Prepare to close the extracorporeal circulation, return the blood, and prepare the heart to restart!"

Everyone's hearts also raised their throats at this moment.

On the heart monitor in the operating room, the heart rate was still a steady straight line.

The nurse started to turn off the cardiopulmonary bypass machine, and the blood in the machine began to flow back into the pure heart from the previously established aortic cannula.

Jiang Li's eyes fixed on Chunchun's heart, which was obviously a size bigger in his chest.

The eyes of everyone in the observation room also stayed on the quiet heart, nervously expecting the heart to beat again.

As the blood returned, the transplanted donor heart began to respond.

Under the continuous impact of blood on the mitral valve of the left atrium, with the bang of the instrument, wide waves began to appear in the straight line on the heart monitor.

Everyone in the operating room also breathed a sigh of relief at this moment.

Jiang Li glanced at the crowd, and said softly: "The heart has resumed beating successfully, and I am going to close my chest!"

The second assistant took the tendon hook, ready to start gradually closing the chest.

However, the moment the tendon hook was removed, the tranquility in the operating room was completely broken.

"Professor Jiang, the patient has unexplained ventricular fibrillation!"

Hearing the cry of ECG monitoring, Jiang Li immediately raised the Kepler binocular magnifying glass hanging on the bridge of his nose, and looked at the display screen.

She clenched her hand fiercely, and the accident she least wanted to see happened.

On the ECG monitor, an abnormal T wave appeared on the screen.

On the operating table, the heavily anesthetized girl began to experience rigidity and convulsions in her limbs, and her cheeks were unusually flushed.

Professor Dong Tianshu hurriedly lay down in front of Chunchun's nose, frowning: "There is intermittent throat noise!"

After speaking, his blood-stained rubber gloves touched the girl's jugular artery.

"The aortic pulse can no longer be touched!"

Jiang Li hurriedly turned his head and shouted at the ECG monitor: "What does the ECG monitor show!"

The nurse standing in front of the ECG monitor glanced at the irregular waveform displayed by the instrument, and immediately replied: "The patient's heart rate waveform is irregular, and it still shows ventricular fibrillation!"

As soon as the words fell, Jiang Li's rubber-gloved hands immediately reached into the girl's chest, tightly holding the newly transplanted donor heart.

She closed her eyes and felt the beating of the donor's heart in her palm. Although she was separated by skin and flesh, the scene of blood flowing through the arteries to the left and right atria of the heart appeared in her mind.

Suddenly, it was as if a lightning flashed in her mind, and in a fleeting moment, she felt an almost undetectable slight movement of the heart.

(End of this chapter)