Come on, Dr. Wu

Chapter 106: Get a hemangioma surgery?

When they were going out, Jia Yu and Yu Xiaoze also came out.

"Are you going to the hospital too?"

"You too?"

"Isn't it the same for you?"

At this moment, all three of them realized something was wrong.

Assessment!

The three people immediately understood that this was the beginning of the second phase of the assessment. Just like last Saturday and Sunday, there was an assessment every day. Yesterday there was a written test, which can be counted as one, so today's test may be the main event.

"come on!"

The three of them said goodbye to each other and entered the hospital.

However, what Wu Xiaofu didn't know was that unlike him, Yu Xiaoze and Jia Yu were not going to the operating room.

Operating room.

Wu Xiaofu saw Xiaojin again, "Hey, Sister Xiaojin, why do you look like you've lost so much weight? Isn't it because you've been working too hard recently?"

"It's not hard work, it's life. I have to come to work on a Sunday. I'm looking forward to when I can go back to normal work. But, have I really lost weight?"

Although Xiaojin lamented that her life was miserable, her eyes lit up when she heard Wu Xiaofu say that she had lost weight.

This made Wu Xiaofu feel a little emotional. Sure enough, the effect of praising a girl for being thin is always more effective than directly praising her beauty. After all, thinness equals beauty. Among girls, it has long been a tacit agreement. Instead, they praise others. , these girls have long been immune to it. No matter whether you are sincere or not, you may be called frivolous.

In the operating room, Duan Hao was studying the film.

Wu Xiaofu said hello and came to Duan Hao. Looking at the film in front of him, he couldn't help but be a little surprised.

"Hepatic hemangioma?"

"Well, large hemangiomas, 9cm in diameter, are rare."

Liver hemangioma is actually very common. During the physical examination in the workplace, one of the four people might have hemangioma. However, most hemangiomas are small hemangioma and do not require special treatment. As long as you live a healthy life, you can eat them regularly. Just check again.
  Liver hemangioma is generally divided into small hemangioma, large hemangioma and giant hemangioma according to the diameter of the tumor. Small hemangioma is 1-5cm in diameter, large hemangioma is 5-10cm in diameter, and giant hemangioma is greater than 10cm. , giant hemangioma is still rare, even the 9cm hemangioma in front of me is rare.

Common hepatic hemangiomas are generally caused by venous vascular malformations, either single or multiple. Almost all of the hepatic hemangiomas discovered so far are benign, and malignant hepatic hemangiomas have not yet appeared.

Therefore, at present, the only indication for surgery for liver hemangioma is that it is too large.

Hemangioma will continue to grow and grow with the continuous supply of blood vessels. It depends on the speed. If the hemangioma is too large, it may affect the function of the liver.

If the hemangioma is too large, the risk of bleeding will also increase. If you wait until it ruptures before performing surgery, it will be too late.

Therefore, if the reexamination is found to have progressed to a large hemangioma, surgery will be recommended.

There are two commonly used surgical methods, one is surgical resection and the other is interventional embolization.

The latter is generally used. After all, compared with surgical resection, interventional surgery is safer and will not cause too much damage to the liver.

Of course, there are advantages and disadvantages.

Expensive!

This may be the biggest disadvantage of interventional surgery. The multiple times of the surgical fee is enough to deter most patients. More importantly, part of the price of interventional surgery is not within the scope of reimbursement, which makes more patients Even if patients are willing to undergo interventional treatment, they must consider the cost of surgery and their own affordability.

Of course, other disadvantages must also be considered.

Just like the liver hemangioma in front of you, its diameter is too large. One treatment may not be able to directly solve it. It needs multiple treatments. Moreover, interventional embolization embolizes the main blood vessels that provide nutrients to the hemangioma. It prevents the hemangioma from receiving blood vessels. Supply, no longer grow, and may cause the hemangioma to shrink.

However, it will continue to remain in the body even after surgery, hidden dangers will always exist, and the treatment period is too long.

There is also the impact of interventional embolization agents. Many people say that interventional embolization agents can cause complications such as abdominal pain, bloating, nausea and vomiting, etc., and affect liver function and metabolism. Of course, this depends on the quality of the surgery and the amount of embolization agents. related.

Now that the patients have entered the operating room, it seems that they have chosen to undergo surgical resection.

From the perspective of general surgery, when hepatic hemangioma is larger than 5cm, direct resection is the first choice. After all, it is more convenient, simple and thorough.

After determining the condition, the pros and cons of the two surgical methods are told to the patient, and then the patient makes his or her choice.

The patient is a woman, not very old, just in her early thirties.

Wu Xiaofu is not surprised. After all, clinically, hepatic hemangioma affects women at a higher rate than men.

Especially for women who are pregnant, studies have found that misuse of contraceptive pills has a higher chance of getting the disease, which is most likely related to the secretion of estrogen and progesterone.

"Teacher, the patient does not consider interventional treatment?"

"Surgical resection is the only means of radical cure. There is a family history of hepatic hemangioma in the patient's family. The patient's mother had hepatic hemangioma. Because there was no physical examination, when it was discovered, the giant hepatic hemangioma had already ruptured and bled. This In this situation, you also know that if it is not discovered in time, the danger will be great.

The patient's mother suffered from hemorrhagic shock. The specific situation was discovered after entering the hospital for investigation. Even after treatment, the liver will inevitably fail. The patient's liver hemangioma progresses very quickly, which may be related to congenital factors. I suggest that the patient first Interventional treatment is performed and observation is done, but the patient still feels that it is better to settle the matter once and for all. "

No wonder!

Wu Xiaofu said he understood that if a 9cm hemangioma ruptures and bleeds, the risk is not small. With such a family history, if it is not completely cured, he may never be able to rest assured.

However, removal of hemangioma requires liver incision, which will affect liver function after all. It is really a pity for such a young person.

Xiaojin is patrolling the station and has almost prepared everything.

Duan Hao is the surgeon, and Wu Xiaofu is the assistant.

"Have you ever had liver hemangioma resection?"

"I've had it." Duan Hao nodded. To be honest, he felt that Wu Xiaofu had had too many surgeries, but he could only think that Wu Xiaofu often used his spare time to do surgeries. Otherwise, it couldn't be explained. How can you be so knowledgeable?

"You've also seen the film, so you can draw it."

Duan Hao was testing him by drawing a line before the operation to see how the incision would be made. However, Wu Xiaofu had personally performed a liver hemangioma resection, so he naturally wouldn't have stage fright.

Take the scribing pen and start working directly.

The surgical incision for surgical resection of liver hemangioma is an individualized incision based on the location and size of the tumor. A long right subcostal incision or a "herringbone" shaped incision is often used. The same is true for this operation, except that the diameter is 9cm. For hepatic hemangioma, the incision should be relatively large so that the tumor can be fully exposed.

Duan Hao looked at Wu Xiaofu's line drawing and didn't say much. He nodded directly. He said too much because he was afraid that Wu Xiaofu would be proud.

"Okay, let's wash your hands and disinfect."

The people who participated in the operation were all old acquaintances. The anesthetist Liu Wengui, the inspector Xiaojin, and the equipment all knew each other. Looking at Duan Hao at this time, they couldn't help but laugh.

They could see how satisfied Duan Hao was with Wu Xiaofu. After all, Duan Hao was notoriously strict. Let alone an intern, even if the attending doctor was brought in for surgery, he would inevitably be criticized a few times. How could he be like these few days? The first time I took Wu Xiaofu for surgery, he was so pleasant and amiable, especially Duan Hao, who seemed to like taking Wu Xiaofu for surgery more and more now.

This can be seen from the fact that they see Wu Xiaofu more and more frequently.

Wu Xiaofu skillfully disinfected and spread the drapes. Duan Hao stood in the position of the surgeon. Wu Xiaofu held the gauze in his left hand and prepared to smoke with his right hand.

The scalpel in Duan Hao's hand is just like the Qinglong Yanyue Knife in the hand of Guan Erye. Every time the scalpel is drawn out, it is a beautiful curve of art. The blade passes through the patient's skin along the scored line, and then the electric knife begins to cut the ligaments. Wu Xiaofu wiped the blood while smoking and sucking the blood. As an assistant, whether the bleeding blocked the surgeon's vision or the smoke blinded the surgeon's eyes, it would be dereliction of duty.

The smell of meat penetrated his nose, making Wu Xiaofu couldn't help but sniff the tip of his nose.

The situation in the abdominal cavity was exposed. Wu Xiaofu had already prepared the retractor and retractor, and opened his field of vision in time. He should do so gently and not with brute force. The patient was under general anesthesia at this time and did not know anything. If you are too rough, , after the patient wakes up, there will be some pain and discomfort, and the skin will become loose due to too rough treatment, making it difficult to recover later.

After a few clicks, the view of the abdominal cavity became clear under the illumination of the shadowless lamp.

Liver hemangioma resection is different from liver cancer resection. Liver cancer resection requires more cuts along the lesion to ensure that the lesion is completely removed without leaving any hidden dangers. However, liver hemangioma generally does not become cancerous, so it is necessary to cut as little as possible, and lymph nodes should also be cut as much as possible. of reservation.

A bulge appeared in the left lobe of the liver, a 9cm hemangioma, which had a huge impact.

A hemangioma that is bigger than a thumb means that the patient cannot see it. Otherwise, he would probably be even more scared. In fact, it is understandable. Anyone who knows that there is such a big hemangioma in his stomach would be extremely scared. After all, it is not Whether hemorrhoids are bleeding or not, you can still know at any time what is in your stomach, which makes you even more scared.

Even if it is not cancerous, it does not hurt people and is harmful to people.

People with small minds may have to think about them every day, and they will not be able to eat well or sleep well. Therefore, modern medicine should also take psychological conditions into consideration when evaluating various diseases and operations.

If you look carefully, you will find that most of the hepatic hemangiomas are buried in the liver, so if you want to completely remove them, you may need to cut a little more.

Duan Hao is very much like a general on the battlefield. He has killed many enemies and experienced many wars. He knows at a glance what kind of enemies are easy to kill. No, he has already started to operate without hesitation. .

"Abrasive tweezers for fine cutting."

Scan the lymph nodes first, which is an inevitable step in liver resection, whether it is a malignant tumor or a benign tumor.

It’s not that they are guilty of anything, it can only be said that they appeared in a place that the surgeon didn’t like to see at a specific time. If they affect the surgeon’s field of vision, if they are not cleaned up, what if due to their influence, they will be cut? , it would be troublesome to cut off blood vessels that should not be cut.

This work can be said to be the most time-consuming operation before the official liver transplantation.

According to Wu Xiaofu's estimate, it would probably take half an hour.

Duan Hao gently opened his forehead, and Xiao Jin Dang started wiping his sweat seamlessly. However, Wu Xiaofu was thinking that Duan Hao didn't sleep well yesterday, and he seemed a little weak. This was just the beginning.

"Teacher, how about I try?"

Ah!
  Duan Hao's movements stagnated, and when he met Wu Xiaofu's eyes, he understood the meaning: This child wants to make progress.

Feeling the pain in my waist, I thought about letting Wu Xiaofu try it?
  After all, Wu Xiaofu has already performed two operations in front of Duan Hao. He still has trust, and it is not small. Lymphatic removal is a delicate job, but it should not be difficult for Wu Xiaofu. It just so happens that he will teach Wu Xiaofu today.

"Okay, then you try."

Wu Xiaofu was immediately happy when he heard this. God knows, he just asked tentatively, and it actually happened. It seems that the scale can be bigger in the future and he can open his mouth more. Duan Hao is too willing to give a chance.

Taking the fine scissors and tweezers, Wu Xiaofu started to move.

In Wu Xiaofu's hands, the scissors and tweezers seemed to have been given life and began to swim around the lymph membrane.

Wu Xiaofu's movements were very gentle, not seeking speed. It was the first time he was cleaning lymph nodes in front of Duan Hao, so it was better not to tease Duan Hao's heart.

Moreover, this is not something that can be done quickly. There are thunders under the lymphatic membrane. If you do it for a short time, you will have to make up for it later and you will doubt your life.

Twenty minutes later, the lymphatic membrane that needed to be cleaned on the left side of the liver had been cleaned by Wu Xiaofu.

Everyone looked at Wu Xiaofu with strange eyes. Even though it was not the first time they saw Wu Xiaofu doing such an amazing performance, they were still shocked every time they saw him. Unlike the previous gallbladder and appendix surgeries, this lymphadenectomy was not an easy task. Wow, Duan Hao was sweating, but Wu Xiaofu completed it perfectly without any guidance from Duan Hao.

Moreover, even Duan Hao would praise the work done well.

The most important thing is that I don’t even sweat a drop, so I still look young.

However, what surprised them was that when they were surprised, Wu Xiaofu actually started asking for sterile gauze.

The instrument was handed over subconsciously, and then he saw Wu Xiaofu using sterile gauze to pad the left lobe of the patient's liver. The process was very careful, just like holding a newborn child, for fear of using too much force. Just cause harm to it.

Of course, this is the most basic quality of the surgeon. Except for the surgical area, no additional damage should be caused to any other body parts to ensure that the patient can recover better and faster.

"a."

He did not rush to give the equipment, but looked at Duan Hao. It seemed that this boy couldn't tell the difference between the big king and the big king. He asked him to scan the lymph membrane. This was a rhythm that occupied the entire operation.

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　　There is another chapter, which is going to be published at 8pm. I feel that if I publish it early in the morning, everyone will be a little tired of following it. How about I change the update time to 8pm?
  　　
  　
  (End of this chapter)