I run a clinic in the United States

Chapter 345: Heart tumor, its root system is actually...

Pancreatic solid pseudo-R capitoma is actually a relatively low-malignant pancreatic tumor that mainly affects young women. If it can be surgically removed, the prognosis is relatively good.

However, although the degree of malignancy is low, if it is not removed, it will be very troublesome, endangering various adjacent organs and even life safety.

After all, this is a tumor.

Even a benign tumor is definitely not a good thing if it grows too big.

Moreover, this kind of tumor can occur in any part of the pancreas. If young women have stomach problems, abdominal pain and other symptoms for which no cause can be found, it is best to investigate in this direction.

No matter what the disease is, early detection and early treatment are the best policies.

It would be bad if a minor illness becomes a serious illness, and a mild illness becomes severe.

When Zhou Qiao takes action, it must be a masterpiece.

The girl is in the hospital and is doing very well and is expected to be discharged soon.

Naturally, their family is also happy. The girl’s mother planned that everyone should celebrate the Lantern Festival. The Chinese New Year is a bleak time, but the Lantern Festival needs a sense of ritual.

Life requires a sense of ritual in order to move forward optimistically in the rugged and difficult life.

The girl began to look forward to campus life again. After recovering from her illness, she could finally return to a beautiful school.

Learning is on the one hand, and on the other...

She was lying on the hospital bed, looking at the scenery outside the window, and the figure of the boy she had a crush on appeared in her mind.

The thoughts that had long been extinguished due to this illness became active again.

"Well, I took a year off from school and was one year behind him. I don't know if I still have a chance?"

It is normal for a girl to be pregnant. Many single female nurses at the County People's Hospital also miss Zhou Qiao every time.

Human nature.

Many women are actually obsessed with appearance. How can they hold back when Zhou Qiao is so handsome and capable?

No, when Zhou Qiao was having lunch in the hospital cafeteria, two bold nurses approached him.

"Doctor Zhou, let me treat you to some milk tea!" One of the girls, with spring eyes and slim figure, stared at Zhou Qiao and said with a smile.

Her eyes were full of burning heat, as if she wanted to eat Zhou Qiao up.

As for the other girl, although she also likes Zhou Qiao, she knows that her appearance is too bad, so she has no extravagant expectations and comes with her best friend.

"Thank you, but I don't like milk tea." Zhou Qiao smiled and declined. He likes milk; he also likes tea. But taken together, well, it actually tastes pretty good.

Zhou Qiao's smile made the girl's heart melt, even though he said rejection.

"Dr. Zhou, do you have a girlfriend?" The girl sat down next to him, moved closer, and asked boldly, touching some places.

Zhou Qiao smiled and said, "Yes."

"Then... you can try a different one and try a new flavor!" The girl recommended herself. It was the first time she said such bold words, and she was really a bit shy.

Couldn't help but get closer.

She smelled the masculine energy on Zhou Qiao's body and couldn't help but feel faintly hot.

Zhou Qiao: "..."

Are all girls today so hot and proactive?

"Well, I've had many girlfriends, and I have many girlfriends." In order to make the other party quit, Zhou Qiao shamelessly told the truth. He does have many girlfriends at the same time. I don’t know how cool it is to be in the United States.

The girl blinked her eyes and said tenderly: "Brother, do you mind having one more?"

"Pfft~" Zhou Qiao was eating and almost squirted out. I go, I can’t bear it, I can’t bear it.

Fortunately, Director Zhang from the cardiac surgery department appeared in time and walked over with a plate: "Dr. Zhou, are you free to go to the cardiac surgery ward later? We have just admitted a patient and feel that the situation is a bit uncertain. "

"Okay, let's go together after eating." Zhou Qiao said loudly.

As Director Zhang came and sat down, the two girls fled as fast as they could.

Director Zhang joked: "I won't disturb your romantic luck, right?"

Zhou Qiao shook his head and said, "It's just the right time."

"Actually, girls are generally not so proactive." Director Zhang smiled and revealed in a low voice while taking a big mouthful of food, "The girl just now is a famous beauty in the hospital. Many people chased her, but she ignored her. She took the initiative to post it just now, and I don’t know how many pairs of eyes were staring at her in the cafeteria. Many single male doctors must have been heartbroken."

"Is it true?" Zhou Qiao looked around. Indeed, many pairs of eyes avoided his gaze.

Director Zhang laughed: "I also listen to the gossip of the doctors in the department."

Zhou Qiao shrugged.

In fact, he is really not interested in ordinary girls now. After eating delicacies from mountains and seas, how can I appreciate the ordinary ones?

The nurse just now is indeed beautiful, with a face value of at least 90 points, but compared with Iris, she is far behind.

If Zhou Qiao wasn't picky about food, he would be able to burp at the County People's Hospital. It's a pity that his eyes are now in the sky.

After dinner, I went to the cardiac surgery ward with Director Zhang to learn about the patient's condition.

The other party suddenly fainted this morning and was sent to the emergency room by colleagues. After an emergency examination, they were shocked to find that there was a tumor in the other party's heart, so he was transferred to the cardiac surgery ward.

The cardiac surgeon notified Director Zhang. With such a serious condition, it was natural to call in Dr. Zhou.

However, Director Zhang did not just invite him rashly, but did some research on his own first. The more he studied, the more suspicious he became.

This condition is a bit strange.

The patient was a woman in her thirties. There was a 70mm*32mm mass in her right atrium, which was probably the cause of her chest tightness and syncope.

However, after further examination after being admitted to the cardiac surgery department, Director Zhang came out of the First Provincial Hospital and had some abilities. He felt that the "pedicle" of the patient's tumor did not seem to be in the heart, but in the inferior vena cava close to the liver. Inside.

If the "root" of the tumor cannot be determined, directly removing the tumor will definitely not work.

This is like cutting off the weeds by removing the roots. Directly removing the tumor is equivalent to cutting off the branches and leaves on the ground, but the roots will still be there, but it will still recur.

And once it relapses, the situation often gets worse.

Zhou Qiao looked at the film carefully and said, "Director Zhang's concerns are correct. Let's do a cardiac magnetic resonance imaging, scanning layer by layer. In addition, focus on scanning the patient's uterus."

"Uterus?" Director Zhang was confused.

Not only was Director Zhang suspicious, the patient and her husband who was accompanying him also widened their eyes.

What the hell? I have a tumor in my heart. Why do I scan my uterus? Is this doctor a rogue doctor?

The patient's husband had the same idea.

However, they suddenly thought about it again and thought to themselves, this doctor is so young, and even the director of the department respects him so much and listens to his orders, could he be the famous Dr. Zhou who came back from the United States to visit relatives?

Has Dr. Zhou left yet?

Zhou Qiao is now a household name in Zhuhai County. Even people who have never been sick at all have heard of such a person at one time or another. However, many people still don’t know what he looks like specifically.

Even some popular celebrities in the entertainment industry are still unknown to many people. It's normal for people not to know Zhou Qiao.

Therefore, further inspection was arranged.

Zhou Qiao and Director Zhang went to the imaging department in person and stared at the scan results.

Sure enough, the tumor's roots were quite deep.

From the heart down, everyone found that even after passing the level of the diaphragm and entering the abdominal cavity, there was still a mass in the inferior vena cava at the level of the liver.

The radiologist followed Zhou Qiao's suggestion and scanned down layer by layer. Soon, the upper abdomen was scanned, but there was still a mass in the veins, so he scanned the lower abdomen again. After sweeping all the way to the pelvis near the base of the thigh, the source of the mass was finally discovered.

It was actually in the womb.

In addition to the heart, the mass in the patient's body extended from the inferior vena cava to the left internal iliac vein.

This is a "winding" and extremely long tumor that climbs from the left internal iliac vein in the pelvic cavity along the inferior vena cava, like a "creeper", all the way to the right atrium.

At the same time, fibroids were naturally found in her uterus as the root cause.

Zhou Qiao said: "It's pretty much what I expected. This should be a case of extrauterine intravascular leiomyomatosis."

Everyone was really shocked!

Radiologist: "..."

Director Zhang: "..."

Patient and husband: "..."

Especially the patients are really confused.

"It took me a long time. Is it caused by gynecological diseases?"

"I'll go. Does Dr. Zhou also treat gynecological diseases?"

This was a rather complex, rare, and difficult case. Zhou Qiao immediately convened teams from the cardiac surgery, gynecology, radiology, anesthesiology, and interventional radiology departments of the County People's Hospital for multidisciplinary consultation.

In fact, I also use this case to teach you a lesson.

Dr. Zhou's lectures were filled with flowers, golden lotuses bloomed on the ground, and those who listened were in high spirits.

Most of the energetic people were young female doctors, who came to "listen to the lectures" and I don't know how active they were.

Especially female doctors from gynecology. Before, they had never thought that they would have the opportunity to cooperate and communicate with Dr. Zhou.

Intravenous leiomyomatosis, a very special type of leiomyoma, can penetrate the uterus, grow into the venous plexus next to the uterus, and grow upward along the veins of the pelvis, all the way along the inferior vena cava. to the heart.

The maximum diameter of the tumor in the patient's right atrium is 70mm. To remove such a tumor that runs through the entire thoracoabdominal cavity, one can imagine the difficulty of surgery!

Therefore, this multidisciplinary consultation took an extremely long time, and the plan formulated by Zhou Qiao was extremely detailed.

"Should the operation be performed on the uterus or the heart first? Is it done in two steps or in one operation?"

"In addition, the patient also has a history of hypertension. How to formulate an anesthesia plan?"

Zhou Qiao explained each question in detail. At the same time, he left time for everyone to ask questions and he would answer their questions.

……

After the consultation, according to Zhou Qiao's plan, the Interventional Radiology Department performed an angiogram on the patient.

It was found that the patient's inferior vena cava had been almost completely blocked by the tumor, and blood from the lower limbs could not return to the heart through this main vein.

This was an important reason for her syncope, chest tightness and dizziness.

Fortunately, I fainted this time and was taken to the hospital and found out.

Otherwise, as time goes by, the condition will become more serious, and life-threatening and sudden death may occur at any time.

In order to minimize the patient's trauma, this operation was performed by Zhou Qiao himself, with Director Zhang of the Cardiac Surgery Department and Director Liu of the Gynecology Department serving as assistants.

There were also several other senior physician assistants. and many assisting medical teams.

Such a major operation is a rare opportunity, so the observation in the operating room and the monitoring room were the same as the previous times, with only a lot more people.

The hardware conditions of Zhuhai County People's Hospital are not bad. After all, they plan to attack the triple B hospital, so they purchased a lot of advanced equipment.

However, the software is not strong enough.

For example, the extracorporeal circulation machine they purchased was never really used after it was purchased.

This should be considered a real first time.

Because of this operation, it was impossible to remove the tumor in the right atrium of his heart with minimally invasive surgery or without stopping the heart. This tumor is too big and long.

With the assistance of two directors, Zhou Qiao first removed the patient's uterus and ovaries to avoid future tumor recurrence due to hormone secretion.

The patient has already given birth to a son and a daughter, so when discussing the surgical plan, the patient and her husband agreed.

Life is more important than anything else, so why worry about so much?

During the operation, Zhou Qiao discovered that there was tumor tissue in the patient's left uterine vein, which was consistent with the previous reading results and confirmed that the previous judgment was correct. The tumor grew upward from the left uterine vein.

Subsequently, under the guidance of Zhou Qiao, the cardiac surgery extracorporeal circulation team established extracorporeal circulation for the patient.

Opening the right atrium and seeing the tumor, Director Zhang took a deep breath.

"Dr. Zhou, it seems like it can't be completely removed?" Director Zhang asked his own question.

If it cannot be completely removed, it will not only cause greater trauma to the patient, but may also result in incomplete tumor removal.

If the cleaning is not thorough, it means cutting the grass without eradicating the roots, and it is easy to relapse.

Zhou Qiao naturally would not allow this to happen.

"It's okay, I'll make a little more incision." There is no doubt Zhou Qiao's ability to adapt to the situation. He moved his hands lightly and soon fully exposed the patient's distal inferior vena cava and left common iliac vein.

The "pedicle" of the tumor was located in the left internal iliac vein. Zhou Qiao incised the patient's left internal iliac vein, left common iliac vein, and distal inferior vena cava, loosened the root of the tumor, then retracted the right atrial wall, and slowly pulled out the tumor.

Half an hour later, an extremely long strip of tumor was finally completely removed. The patient's heart was restarted successfully.

The entire operation actually didn't last long, just over an hour.

This made all the medical staff involved in the operation admired and said that their eyes were opened!

Because for such a complicated surgery, everyone thinks that it is normal to perform it for five to six hours, or even seven or eight hours.

Who knew that Dr. Zhou was so "clean" and could finish it in just over an hour?

Dr. Zhou's action was naturally quick.

Some things must be done quickly, because extracorporeal circulation has a great impact on the patient. If the time is prolonged, the re-circulation may fail.

Zhou Qiao is very measured. When can he slow down a little and give everyone more time to observe and watch more carefully, but when he must speed up, he will not hesitate.

Because the quality of the surgery is top-notch, the patient’s recovery after surgery is also excellent.

The next day, after Zhou Qiao's ward rounds, he informed the patient and his family that he should be able to be discharged smoothly in a week at most, before the Lantern Festival.

The patients and their families were shocked. Can you be discharged from the hospital so quickly after such a major operation?

They were all mentally prepared to stay here for a month or two.

However, the recovery in the next few days proved that Zhou Qiao's prediction was quite correct.

The patient's family has no choice but to customize a banner.

　Thanks to "Floating Post-500s" for the -point reward.

　　

　

(End of this chapter)