Dr. Chung’s 90s

Cheng Lei said this long series of words with great effort, and Zhong Yu heard both joy and sadness in his ears.

Her happiness comes from the opportunity to explore new diseases, but her sadness comes from the dual physical and psychological torture Cheng Lei suffered.

Zhong Yu solemnly said: "Although I am young, I have handled many cases. I have worked in Nanshan Hospital and Military General Hospital, and I have helped many patients regain their lives, so I will do my best to help you. You can try Just trust me."

Cheng Lei was a little surprised to hear what she said. When he came, he was in a state of high tension and trance, and he had not read Zhong Yu's resume.

He hesitated and said: "Dean Zhong... I will not have any family members accompanying me during the treatment... I will sign all the words myself... Is that okay?"

Zhong Yu looked embarrassed. After all, the probability of encountering emergencies during treatment was quite high.

"If possible, you'd better find a friend to accompany you. If something happens, I can also ask for his advice."

Cheng Lei lowered his head and thought for a moment, searching in his mind for someone who could come over.

"If it doesn't work... just ask my colleague to come over..."

Zhong Yu didn't object, as long as someone accompanied him, asking too much would increase Cheng Lei's burden.

After arranging for Cheng Lei to go through the hospitalization procedures, Zhong Yu called Guo Pengfei and Cai Yizhong over and discussed the surgical plan with them.

Zhong Yu was exposed to such a disease for the first time, and it was the same for both of them. Guo Pengfei frowned when he looked at the medical record, and said in a heavy tone:
"In this case, the patient must undergo a total tongue resection, floor of mouth and partial tongue base resection of the lower lip and mandible through a median incision under general anesthesia with tracheostomy and intubation. If the tongue body cannot be reconstructed in time, even basic life will be difficult in the future. There is no guarantee, this operation is indeed a bit tricky.”

Cai Yizhong took the medical record from his hand and said calmly: "Since the dean has taken over, he must have a suitable surgical plan. Don't worry about it."

His original intention of saying this was to highlight Zhong Yu's abilities, but it sounded like he was being flattered. Zhong Yu said displeased:
"I called you here because I wanted to hear your opinions. I didn't want you to argue. If you can't come up with constructive opinions, then stop talking."

Cai Yizhong's expression was stiff. After adjusting his condition, he said:
"Dean, is this operation divided into two groups, one group for resection and the other for skin flap preparation?"

Zhong Yu nodded and said: "That's what I imagined. Otherwise, we won't have enough time and the task for you two will be very heavy this time."

Guo Pengfei said: “Depending on the size of tongue and floor of mouth defects, various skin flaps or myocutaneous flaps can be used for repair, such as platysma myocutaneous flap, sternocleidomastoid myocutaneous flap, trapezius myocutaneous flap, pectoralis major myocutaneous flap, etc. Myocutaneous flaps and forearm free flaps, etc., but these repair methods each have their own advantages and disadvantages, which flap should we choose?"

Zhong Yu said without hesitation: “The pectoralis major myocutaneous flap has a large amount of tissue and is particularly suitable for filling and repairing large muscle defects in the entire tongue body and floor of the mouth caused by radical resection of tongue cancer that invades both sides.

The flipping of the pectoralis major muscle pedicle can just cover the exposed large blood vessels in the neck after neck dissection, playing a protective role. It can also reduce the neck depression deformity after neck dissection and restore the plump appearance of the neck. "

Guo Pengfei also felt that it made sense. Cai Yizhong was not willing to be outdone and said:
"Dean, if the operation is divided into two groups, I will prepare the myocutaneous flap. I think I am relatively skilled in this aspect."

Zhong Yu said with a serious face: "The survival of the pectoralis major myocutaneous flap is very important, and in order to reduce postoperative complications, we must pay special attention to several points when designing, cutting and transferring the flap."

Cai Yizhong quickly took out his notebook to take notes, and Guo Pengfei did the same. Zhong Yu continued:
“The length of the muscle pedicle must be sufficient, and the vascular pedicle cannot be stretched after the myocutaneous flap is sutured in situ.

Reconstruction of the entire tongue body and floor of the mouth requires a longer pedicle of the pectoralis major myocutaneous flap, and the length of the muscle pedicle to be removed is determined based on the distance from the base of the tongue to the lower edge of the clavicle.

In order to ensure a long enough muscle pedicle length, we designed the lower edge of the skin flap to extend 3 to 6 cm beyond the lower edge of the pectoralis major muscle and reach the anterior sheath of the rectus abdominis muscle. The anterior sheath of the rectus abdominis muscle was also lifted up to ensure sufficient coverage of the flap. blood supply, and the thinner part of the skin flap beyond the lower edge of the pectoralis major muscle is used to make the free end of the tongue and the floor of the mouth area, with a more natural and lifelike shape. "

Cai Yizhong listened very carefully. This was more complicated than other cases he had handled. Zhong Yu added:
“If the pectoralis major myocutaneous flap is passed under the clavicle, the subclavian tunnel preparation must be loose enough, and the medial periosteum of the clavicle can be incised and peeled off to reduce tension.

However, care should be taken to protect the subclavian artery and vein and avoid penetrating the pleura. After full relaxation and tension reduction, the tunnel should be able to accommodate 3 or 4 fingers.

The pectoralis major myocutaneous flap cannot be pulled vigorously when passing through the tunnel to prevent shearing force between the skin and muscle from damaging the skin perforators. "

Cai Yizhong listened carefully, and Guo Pengfei also paid full attention.

“The last point is that after the myocutaneous flap is introduced into the mouth, fix the edge of the muscle pedicle and the neck muscles with a few pins to prevent the vascular pedicle from twisting and being stretched under the action of gravity. You only need to prepare the flap well, and I will do the rest. "

Despite this, every time Zhong Yu said something, Cai Yizhong felt more pressure. The greater the pressure, the more techniques he could master. The coexistence of opportunities and risks is the norm, and Guo Pengfei also understands the reason for this.

Zhong Yu saw Cai Yizhong's serious face and said calmly:
"Can you do the above? If you can't, leave it to me. It doesn't matter if the operation takes a long time. We can't let the patient bear the risk."

Cai Yizhong immediately said: "I can do it, leave this step to me."

Zhong Yu was satisfied with his answer. She didn't mind taking them with her more, but she couldn't stand in front of them all the time.

"Okay, you should think about it first. The patient's physical condition is not very good, and the operation must be carried out as soon as possible."

Coming out of Zhong Yu's office, Guo Pengfei walked in front and Cai Yizhong followed closely behind him. Cai Yizhong was a little farther away from the office before he shouted:
"Guo Pengfei, I think we need to have a good talk."

Guo Pengfei turned his head and mocked: "What do we have to talk about? Aren't you always targeting me?"

Cai Yizhong didn't want the two of them to get too tense. He apologized: "It was indeed my fault for not controlling my emotions that day. I hope we don't bring this to the table. The dean will be unhappy when he sees it."

Guo Pengfei sneered: "Do you still care whether Dean Gao is happy or not? This is a bit too ridiculous."

Cai Yizhong shrugged and chuckled:
"There is no need for us to have such a quarrel. If the snipe and the clam fight, the gain will outweigh the gain. I thought before that if you want, we can have a meal together. This place is different from Nanshan Hospital. I have just adapted to it." .”

For a person like Cai Yizhong, it is extremely rare for him to show weakness. Guo Pengfei has no intention of continuing to compete with him. After all, the two of them are not the same person, so they will not be in trouble. Since the other party takes the initiative to seek peace, he also Just be generous. "You don't have to eat anymore. Just stop picking on me in the future. I'll leave first if I still have work to do."

Cai Yizhong looked at his leaving figure and was not angry. Previously, he was disappointed and dissatisfied with Xiangxiang and had a strong competitive spirit. The combination of various reasons would inevitably lead to an unbalanced mentality.

Now that he has adapted to the new environment and understands what is most important at the moment, it is more beneficial for him and Guo Pengfei to remain friendly.

Zhong Yu devoted all her attention to her work again. She repeatedly considered the surgical plan, and called her classmates in the oncology department for their opinions. She did not forget to discuss it with Ji Xueli when she got home, and finally decided on the surgical plan.

When she arrived at the ward with the informed consent form for the operation, she saw Yu Yue, the famous host of the city's TV station, sitting in front of Cheng Lei's bed. Before Zhong Yu asked, Cheng Lei introduced:
"Dean Zhong... Yu Yue is my colleague... I can ask her to sign the relevant procedures during my operation..."

Zhong Yu was not curious about their relationship. She handed over the informed consent form for the surgery and said politely:
"Miss Yu can take a look at this first and then sign."

Yu Yue dressed very low-key. After she read the contents of the consent form, she asked with some concern:
"Dean Zhong, our Director Cheng's condition is very serious. Is there a high risk of surgery?"

Before Zhong Yu could say anything, Cheng Lei said: "Yu Yue... just sign... I know what I know..."

They were colleagues in a superior-subordinate relationship, and it was not Yu Yue's turn to say some things. She sighed and did not say anything more. After she signed the contract, Zhong Yu said seriously:
"Don't eat before the operation. We'll go to the operating room later. The nurse will come over soon to prepare the skin."

Cheng Lei nodded calmly. After Zhong Yu left, Yu Yue advised:
"Director, your illness is not a minor one. The risk of choosing to treat it here is too high. This Guangfu Hospital is a little-known hospital. It was established less than a year ago and the director is so young. What if something happens and someone runs away? manage?"

Cheng Lei smiled miserably, and said with a stiff tongue:
"Can I cure the disease if I go to a big hospital? For me...it's the same wherever I go."

Yu Yue turned her head away unbearably. She never thought that the talented deputy director Cheng of their TV station would suffer from such a disease. It was useless to talk about it at this point, so she could only take good care of him as much as possible.

The two of them had a lot of contact because of their work relationship. Apart from their work contacts, they rarely contacted each other in private. It was difficult for Yu Yue to refuse his sudden request for help. She couldn't help him much and could only hope that his operation would be successful.

After everything was ready in the operating room, Guo Pengfei and the nurse came to pick up Cheng Lei. At such a critical moment, Cheng Lei was particularly calm.

Zhong Yu saw that he didn't say much. His tongue was stiff and it was difficult to pronounce, so why bother him.

In his case, he had to perform a tracheotomy first, and intubate the tracheotomy site under general anesthesia. There was no need to change the patient's position during the operation, and a "double-group operation" was performed.

Zhong Yu's group performed a complete resection of the tongue body, floor of the mouth, and part of the tongue base through the median sawing approach of the lower lip and mandible. In accordance with the treatment principles of head and neck malignant tumors, radical neck lymphadenectomy and lateral pectoralis major myocutaneous flap were performed. Functional neck lymph node dissection was performed on the other side. During this period, she also quietly used resurrection vine juice in order to prevent later recurrence.

Zhong Yu didn't know if the juice of the resurrection vine had this effect, but it was better than nothing. If it really didn't work, she would feel guilty.

The other group was operated by Cai Yizhong, who completed the preparation of the pectoralis major island myocutaneous flap.

After the preparation of the myocutaneous flap is completed, Zhong Yu will pass it through the subclavian tunnel or overturn it through the supraclavicle and introduce it into the mouth according to the size of the myocutaneous flap. After suturing the myocutaneous flap, the sawed incision in the middle of the mandible will be reset. Micro titanium plates are used for solid internal fixation.

The chest donor area was subtly dissected to make additional incisions and then pulled together and sutured. Negative pressure tubes were placed at the neck and chest wounds for adequate drainage to prevent blood and fluid accumulation in the surgical area.

The entire operation took more than eight hours, and Zhong Yu's online status showed no lag at all. Cai Yizhong and the others could not tell that this was her first time doing this type of surgery.

When the drainage tube was placed and the operation was successful, Zhong Yu still did not relax. She said to Guo Pengfei:
"Please work hard, monitor the patient's vital signs closely after the operation, strengthen tracheostomy care, and closely observe the color and texture changes of the transferred myocutaneous flap so as to detect possible vascular crises early. Don't worry about anything else for these two days."

Guo Pengfei said sternly: "Don't worry, Dean, I will stay with you until he passes the dangerous period."

Zhong Yu nodded, and then someone pushed him to the intensive care unit. As soon as the operating room door opened, Yu Yue stepped forward and asked anxiously:
"Dean Zhong, how is Director Cheng?"

Zhong Yu took off the mask and comforted him: "The operation was successful. After 48 hours of observation, it is confirmed that there are no other postoperative complications before he can be transferred to the general ward."

Yu Yue's anxious heart finally relaxed a little, and she said gratefully: "Thank you, Dean Zhong!"

Zhong Yu waved his hands indifferently and left. Chu Jianwen followed her. When they were far away, she whispered softly:
"The local TV station's famous actress is quite annoying to watch. Her facial features are not as refined as yours."

Zhong Yu was used to her occasional outbursts, so he said in a good-tempered tone:
"Yu Yue's face looks three-dimensional in front of the camera. Not everyone is suitable for facing the camera. I have watched the show she hosted. Her script skills and ability to adapt to changes are very strong. She is quite capable."

The most indispensable thing for a place like a TV station is a pretty face, and Yu Yue can certainly stand out because she has real abilities.

Chu Jianwen agreed with this, and she suddenly thought:
"You said that this time we cured Deputy Director Cheng, will he promote our hospital for free?"

Zhong Yu put away the surgical clothes he had changed into and said nonchalantly:
"We are a hospital, not a vegetable market. Publicity is annoying. If you have that kind of concern, it would be better to focus more on the patients."

Chu Jianwen smiled and said: "You can't say that. The smell of wine is also afraid of the alley. The TV station's publicity effect is extraordinary."

Zhong Yu still doesn't catch a cold. "There are too many patients and I can't handle it. I don't want too many people to pay attention to our hospital. People are afraid of being famous and pigs are afraid of being strong. It's better to keep a low profile for safety."

Chu Jianwen leaned against the wall and said with emotion: "Your calm temperament is beyond your age. It would be nice to pay less attention and have less trouble. By the way, I have also been invited to the Ye family's birthday party. Posted, how about we go shopping together in the evening?"

Zhong Yu was worried and Cheng Lei frowned and said, "Let's go at noon tomorrow. If there is an emergency at night, Guo Pengfei won't be able to handle it alone."

Chu Jianwen shrugged, "Okay, I'll get busy first."