Oncology Physician Life

Chapter 85 Chapter 84 A Life-Determining Surgery

Time soon entered September, ushered in the beginning of autumn, the camphor trees in the garden outside the hospital were covered with yellowing leaves, and the oncology department also ushered in a new batch of young interns.

Monday is still the day when departments are handed over.

The new batch of interns sent from various medical schools were waiting outside the corridor of the handover department early.

Everyone is wearing brand new white coats with straight ties inside. On their young and immature faces, there is always a bit of anxiety and nervousness, and more of longing and hope for the future.

Tan Tan has been officially promoted to Chief Resident, followed by Xu Youshu and Shu Yusheng who were also promoted to Resident.

In the scheduling room, on the LED display screen hanging above everyone's heads, a teaching operation in the operation center yesterday was being played on a loop. This operation alone was enough for an intern to study for a period of time.

"Have you heard?"

Xu Youshu opened the shift list, and asked Shu Yusheng calmly, "There is an old leader in the industry, the stomach cancer operation will be performed by the chief director himself, and it will be in the morning, maybe we can catch up to observe it after the shift. "

Shu Yusheng was holding a book of medical materials in German and was concentrating on it. Hearing Xu Youshu's words, his brows behind the gold-rimmed glasses frowned, "It seems that the chief director has not performed surgery for many years. How could it be so sudden this time?"

"It may be that the patient's status is quite special. The chief director of our oncology department was also a top expert in the field of gastric cancer and colorectal cancer at the time. There are not many people who can let him perform surgery in person."

Tan Tan listened to the two discussing in a low voice, and asked: "The shift will be over soon, and Professor Ji will probably ask about the case and operation plan of the eight-bed patient. You two should pay attention."

"Eight beds?" Xu Youshu was taken aback, "The patient with suspected peptic ulcer?"

Shu Yusheng looked at Tan Tan suspiciously: "I heard that the result of the occult blood reaction of the eight-bed patient was weakly positive, and the gastric acid level was very high beyond the normal standard. Is it really just an ordinary peptic ulcer?"

Tan Tan shook his head: "So patients with ambiguous test results like this have to let Professor Ji make up their minds in the end!"

Xu Youshu asked: "Does Professor Ji have to watch the film on the spot and analyze it on the spot?"

Tan Tan nodded: "Very likely."

Xu Youshu looked at Shu Yusheng who was beside him, looked at his cold face, and whispered flatteringly, "Dr. Shu, can you work with me as a team for this surgical task that the director doesn't know about?"

"No!" Shu Yusheng glanced at him, "Last time I was on the same team as you, and I got a C grade in the surgery test. I really suspect that your hands are pig's hooves. How can you be so stupid that you can't even order them in the surgery?" They can all be wrong!"

Xu Youshu gritted his teeth: "Isn't it a drag on you, a genius who came back from Hokkaido? As for running on people like this, at worst, I'll just be in my own group."

Shu Yusheng continued flipping through the German materials in his hand: "Seeing that you have invited me to lunch for a week, if there is anything you don't understand about the operation, you can still ask me anytime."

Xu Youshu snorted coldly: "That slave really wants to thank the Lord for his kindness!"

Shu Yusheng closed the surgery materials in his hands, a smile appeared on his gentle and humble face: "You're welcome."

Zhang Linlin didn't know when she came in. Hearing the bickering between the two, she was amazed: "Both of you have become first-line doctors, and you are also residents with interns. Why are you so childish?"

Xu Youshu noticed Kang Jun walking through the corridor, looked at his lonely expression, and sighed: "I heard that Dr. Wei Ranwei of the oncology department has really resigned. It is estimated that he will leave at the end of this month. Dr. Wei is Kang Jun." Kang Jun must be very reluctant to teach you, right?"

Mentioning this incident attracted a lot of people's attention, Zhang Linlin shook her head: "I heard that Director Song of the Medical Oncology Department deliberately suppressed Dr. Wei's resignation letter, and it took more than a month. I insisted on resigning to become a singer, but I heard that the manager in charge of Dr. Wei is actually Director Song’s daughter Song Qin, and because of this, Director Song almost severed the father-daughter relationship with his daughter.”

Xu Youshu said with emotion: "Is there so much competition in the entertainment industry now? The agent has poached his own father, but it's really a pity that Dr. Wei left."

After a while, Wei Chen came in with the materials of the transition, glanced at many young interns, and clapped his hands: "This round of transition is the first time for your group of interns to come to the hospital. Give me [-] points of energy, don't let me lose the chain in front of the director!"

On the other side, in the underground parking lot of the hospital, Ji Han turned the car into the parking space all the way. Before the car stopped, Jiang Li opened the door and got off the car without waiting.

She was still holding a box of hot beef and toast in her hand, standing in front of the trash can, waiting for the elevator to go down, stuffing the bread into her mouth with a few mouthfuls, and drinking milk in big gulps. After finishing his drink, he picked up his briefcase, adjusted his black suit jacket in front of the shiny tempered glass of the elevator door, and changed his sneakers.

Ji Han stood beside her, looking at the metal elevator door as a mirror, with his slender hands straightening the neat straight tie on the white shirt.

"If you hadn't insisted on watching some midnight movie with Pei Xiaonan last night, you wouldn't be late today on Monday."

Jiang Li didn't say a word, he just pulled up his loose hair and tied the ponytail with the hair rope on his wrist, then he calmly replied: "Didn't you not ask any questions at the midnight movie yesterday? Now I'm late, and I'm putting all the responsibility on me, if it wasn't for your delay on the way for a few minutes, how could I be late?"

Just as Ji Han was about to argue with her, the elevator doors opened, and the inside was almost full of people. Jiang Li glanced at his watch, and it was too late to wait for the next trip, so he forced himself to squeeze in.

Ji Han is going to follow the ward rounds this morning, and he will be late soon, so he can only follow along.

At the moment when his front foot came in, the elevator overload alarm bell rang.

But Ji Han didn't have the slightest intention of quitting, he still stood in.

The harsh alarm made Jiang Li frowned unhappily. She glanced at the crowds in the elevator and whispered to Ji Han, "I'm really going to be late. At this time, shouldn't you take the initiative? ?”

Ji Han frowned: "I'm going to follow the big rounds this morning, and there's also an MDT academic conference."

Jiang Li was unhappy, "There's no reason to let a woman go down, is there?"

The people in the elevator were a little impatient.

"Those who come up later, be conscious, everyone is in a hurry!"

Jiang Li squeezed into the not-so-spacious elevator, and looked at Ji Han who was still standing motionless inside the elevator door, winking at him.

Gritting her teeth, she whispered, "Get down!"

Ji Han covered the corners of his lips with the back of his hand, and coughed awkwardly: "I'm in charge of the big rounds in the morning. I'm in a hurry, and there is an MDT meeting at nine o'clock. This can't be delayed. You should have nothing to do in the morning?"

Jiang Li rolled his eyes, unmoved.

Ji Han raised his eyebrows, and Jiang Li pushed him out of the elevator before he could move.

Listening to the siren that was no longer ringing, Jiang Li couldn't wait to press the button to close the elevator.

She watched the elevator door slowly close in front of Ji Han's expressionless expression, waved at him happily, and whispered, "Professor Ji, see you at the hospital!"

10 minutes later……

Jiang Li anxiously ran towards the office, and finally clocked in at the last second, completed the sign-in, and walked into the office, just one second away, she might not be able to win the full attendance award this month.

At this time, outside the ward, Qi Song, the director of the oncology surgery department, had already arrived, and the chief resident and attending physician of the oncology department were waiting for Ji Han in the corridor. I can change it in time.

Wei Chen hurriedly brought over the spare white coat and put it on for Ji Han.

Qi Song glanced at the time and said with a smile: "Professor Ji, you are rarely late on such occasions?"

Ji Han glanced at the group of people waiting for him, and apologized rather embarrassedly: "I'm sorry, I wasted everyone's time, and there was a traffic jam when I came."

Qi Song didn't pursue it, everyone walked into the ward, Wei Chen took the patient's case from the intern at the side, and said first: "This is the patient who was admitted to the hospital the day before yesterday. The CT scan taken yesterday shows the small curvature of the patient's stomach. Obvious large ulcers can be seen on the film. The attending doctor preliminarily judged that it was a typical peptic ulcer, but the patient reported that he had heart pain three months ago, and the occult blood test for gastric cancer was weakly positive. The degree is very high beyond the normal standard. Tan Tan is the hospital director in charge of the patient, and he insists that it is gastric cancer. The attending doctor said it was just a typical peptic ulcer, because no cancer tissue can be seen on the film, so this rounds, I want to let you Show me."

Ji Han pointed to the film in his hand: "Slight sclerosis has appeared on the left side of the gastric curvature. From the film, it can be seen that the area is very large. Even if no tumor is detected by the gastroscopy, it may be quite serious, right? No. It's just as simple as peptic ulcer!"

The attending physician in charge of this patient hurriedly stood up from the crowd: "For safety's sake, I plan to perform a gastrectomy to remove this part of the ulcer."

Ji Han glanced at Wei Chen: "Just follow the attending plan, let Tan Tan act as the first assistant for this operation, and record the patient's postoperative reaction throughout the process, and give it to me after making a report."

The attending doctor on the side nodded hurriedly, looking at Ji Han's sharp eyes behind his glasses, he was afraid for a while.

Soon Shu Yusheng took out another film and began to interpret: "This patient in the third bed has a large area of ​​gastric ulcer. If gastrectomy is performed, the anastomosis is predicted to be unsatisfactory, which may cause empyema to a large extent. symptoms, or even peritonitis in the worst case, endangering the lives of patients."

Ji Han brought the film over, facing the sunlight coming in from the window, looking at the image on it, he agreed with Shu Yusheng's opinion: "Then do you have any good solution?"

Shu Yusheng hesitated for a moment, then shook his head: "I haven't figured it out yet."

Ji Han glanced at him: "Now that you know how to read more books, you should learn to use it more flexibly. There are more than one cases of this kind of patient in the world. The Germans discovered this kind of patient as early as 1987, but in After gastrectomy, the patient developed severe empyema and died after living for only 37 days. Therefore, there has been a long debate in the medical community about whether to perform total gastric surgery or non-total gastric surgery for such patients. , both surgical methods have their pros and cons.

Speaking of Ji Han, he pointed to the film with his finger: "When I was abroad, many surgeons would use a safer method when encountering this kind of patients, that is, after removing the whole stomach, the stomach incision and the twelve finger joints will be removed. Intestinal suturing, but if this is done, the anastomosis will be incomplete, and the probability of secondary ulcers will be high. Therefore, there is a second method, suturing the stomach incision and the head of the pancreas, which reduces the The incidence of ulcers and the problem of empyema caused by incomplete sutures, but the disadvantage is that this method will cause the loss of the patient's digestive system, which will have a great impact on postoperative recovery, and even the quality of life will be seriously reduced in the future. Strictly control your diet."

Upon hearing this, Shu Yusheng said, "But I still stick to the first method, trying to improve the patient's quality of life."

Ji Han glanced at him, but didn't reply. He didn't say that Shu Yusheng's choice was wrong, because no matter which surgical plan he chooses, there are pros and cons. Fully explain the pros and cons, and let patients and their families choose for themselves!"

On the other side, the surgery center of the oncology department.

This gastric cancer operation was performed by Liu Chong, director of the Department of Oncology.

The status of the patient is very special and he has a high prestige in the industry.

Originally, the patient was too old and the risk of surgery was high, so Liu Chong did not intend to take over, but when the director Li Zhongfu officially retired in the next year, the competition for the nomination of the new director was fierce.

If Liu Chong can complete the operation at this time, it will be a great help to his competition for the position of dean.

The 71-year-old man lying on the operating table suddenly suffered from pleural effusion before the operation, causing respiratory failure. Hemorrhage in the cavity during the operation, coupled with heavy anesthesia, made the patient's already old face even paler.

Holding a scalpel in his hand, Liu Chong was meticulously clearing out the lymph glands around the patient's stomach.

His voice still sounded majestic and resonant.

"Vascular clamp."

"Hemostatic forceps."

"A pointed scalpel."

"Electric knife."

Whenever Liu Chong's loud voice sounded, the assistants on the side handed over surgical instruments such as vascular clips, hemostats, and scalpels in an orderly manner.

With his swift movements, the cancer cells that had metastasized to the patient's lymph glands were quickly eliminated.

Under the bright shadowless lamp, Liu Chong replaced the pointed scalpel in his hand. He cleared all the patient's lymph nodes infected with cancer cells, and began to peel off the esophagus.

He skillfully operates every step.

The first assistant and the second assistant used hemostatic forceps to stop the bleeding while he was clearing out the cancerous tissue simultaneously.

Because the patient is an old and influential local leader in the medical field, in addition to President Li, there are even several big leaders in the hospital sitting in the observation room. Everyone attaches great importance to this operation.

Liu Chong knew very well that this operation could be entrusted to him, largely because of his reputation and reputation.

At the same time, with the knife in his hand, he also bet his reputation and future in the industry.

Putting down the scalpel, Liu Chong looked at the blood-oozing abdominal cavity, the gastric body, which had been distorted and deformed due to cancer, had a large area of ​​necrosis.

He took the scalpel from his assistant without hesitation and began to separate the stomach.

Everything went according to plan and went very smoothly.

In the observation room, everyone's hanging hearts also fell to the ground.

"After all, Liu Chong has led the oncology department for so many years, and his ability and ability are still very powerful."

Hearing the leader's words, Li Zhongfu smiled, and responded: "Naturally, Liu Chong is the top expert in gastric cancer and colorectal cancer in our hospital. I can rest assured that this operation performed by the old leader will be entrusted to Liu Chong."

Time passed little by little.

Just when Liu Chong was holding the scalpel and was about to cut off the necrotic stomach body, his hand holding the scalpel suddenly trembled obviously.

Liu Chong took a quick glance at his abnormal hand from the corner of his eye, gritted his teeth to stop the trembling of his hand, and continued to extend the pointed scalpel towards the stomach.

The first assistant and the second assistant around the operating table also obviously noticed the trembling hands of the chief director Liu Chong, looked at each other, and saw the shock and panic in each other's eyes.

Yisuke hurriedly asked, "Director Liu, is your hand okay?"

Liu Chong looked up at the observation room on the other side of the operating room, with a smile on his face: "It's okay, continue with the operation."

Liu Chong didn't expect that the problem in his hands happened at this time, but he couldn't miss this opportunity, as long as he completed the operation perfectly, the next dean's seat would most likely be his.

He glanced at the right hand holding the pointed scalpel, even though he was already firmly holding the handle of the scalpel, his whole wrist would still tremble uncontrollably.

He glanced at the stomach in front of him, as long as he cut this last cut, as long as this last cut, it means that he will take the position of dean in his pocket.

Since he was an intern, he has been secretly accumulating strength for this position in the battle for the rights of this giant white tower. Now, his goal is within reach, and he, Liu Chong, must not have any accidents.

Liu Chong clenched the pointed scalpel tightly in his hand, and bravely cut off the necrotic stomach body in the patient's abdominal cavity.

Almost everyone in the operating room noticed the abnormality of the chief director Liu Chong. Almost everyone held their breath, watching the knife he swung like a god of death wielding a sickle.

With this action, it also means that the necrotic gastric body is completely cut off.

But it was just this simple knife, but Liu Chong seemed to have exhausted all his strength, squinting his eyes and panting heavily.

He lowered his head and stared blankly at the blood-stained rubber gloves, with fear in his eyes.

Suddenly, the first assistant, who was recording the data of the instrument, lost his mind in a hurry, and shouted dryly: "Director, the patient's blood oxygen saturation has begun to drop rapidly, and the ECG has fluctuated, indicating that the patient's ventricle has suffered sudden arrest!"

The second assistant, who was stopping the bleeding, was still holding the excised necrotic gastric organ in his hand. Before he could move, a part of the blood vessel that had just been sutured in the patient's abdominal cavity suddenly burst open, and a column of blood splashed all over his face. It completely stained his frowning brows and the blue medical mask under the bridge of his nose.

He frantically held the hemostat, but seeing that the abdominal cavity was already filled with blood, he didn't know where the broken blood vessel was.

Although Liu Chong cut off the necrotic stomach body with the knife just now, it also cut off a certain blood vessel at the same time.

Liu Chong's face paled in an instant, looking at Kazusuke who started to suck blood, his eyes narrowed slightly: "Why are you still standing there, quickly find out the breakpoint of the blood vessel!"

As he said that, he pushed away the position of the first assistant, and looked at the blood oxygen saturation that had dropped to zero, and the electrocardiogram approaching a smooth straight line, with an unprecedented solemn expression.

The instrument alarms.

Patient with heart failure.

The heart stopped beating completely and the sirens blared.

Looking at Liu Chong whose abdominal cavity was filled with blood, he stretched his hands with rubber gloves into the blood-filled abdominal cavity.

If he could not find the bleeding point and stop the bleeding within 3 minutes, his future as a doctor and even the dean in this giant white tower would be ruined along with this operation!
In the operating room, no one dared to make a sound. To find the bleeding blood vessel blindly in the blood-filled abdominal cavity within 3 minutes was tantamount to finding a needle in a haystack.

In the observation room, Dean Li suddenly stood up from his seat, and the leaders behind him were also full of anxiety.

"How did this happen? What happened? Why did such a good operation suddenly appear?"

"Dean Li, didn't the surgery go well just now?"

"Dean Li, what should we do? Think of a way!"

Li Zhongfu looked at Liu Chong who was still looking for a broken blood vessel, gritted his teeth, and shouted at the nurse outside the door: "Go quickly, let Professor Ji come to the operating room immediately!"

Liu Chong, who put his hands in his blood-filled abdomen to search, suddenly froze anxiously, and glanced at his right hand in disbelief. The momentary numbness of his thumb made him look shocked again.

The door of the operating room behind him was pushed open at this time, and Ji Han's slender figure walked in quickly.

He turned around in front of the two itinerant nurses holding up the surgical gowns, neatly fastened the straps on the back of the surgical gowns, and dressed neatly.

At the same time, he raised his hands with rubber gloves in front of his face and came to Liu Chong's side.

Liu Chong looked at the extremely young Ji Han beside him, and frowned.

Ji Han's calm eyes and Liu Chong's deep eyes meet in the air in an instant!
(End of this chapter)