medical treatment

Chapter 269
On the Tuesday afternoon of the next day, Yu Zhiming received a diagnosis from a middle-aged Taoist priest, mainly due to heavy metal poisoning such as nickel.

The possibility of the source of poisoning, according to the Taoist himself, once camped and lived in a deserted place with clear water and beautiful water, and practiced for two or three months.

At that time, I drank mountain spring water from a small spring every day.

Yu Zhiming was also told that the hospital had notified the local geological prospecting department to take samples for testing, and maybe a nickel mine could be found.

Yu Zhiming also learned from Teacher Qi Yue that finding ore deposits through endemic diseases is an effective way to find ore in the early years.

At nearly 06:30 in the evening, Yu Zhiming hurried to the General Surgery Department after completing the rapid screening of gastric and liver cancer among fifty volunteers of the Very Early Cancer Project.

He accepted Dr. Wang Jiangyue's invitation to assist her in completing a kidney transplant operation.

Yu Zhiming knew that this was a study and practice opportunity specially given to him by Dr. Wang, and he appreciated it very much.

This is the first time he has participated in a human organ transplant operation since he practiced medicine, and he is very excited and looking forward to it.

Therefore, Yu Zhiming rushed to the general surgery department immediately after finishing his scheduled work for the day.

However, Yu Zhiming couldn't see Dr. Wang in the office, so he went to the ward after asking.

He rushed to the ward again, saw Dr. Wang Jiangyue who was telling the patient about the operation, and also saw the patient and the kidney donor who were going to have the operation tonight.

The patient is a 35-year-old man with advanced uremia, which caused the loss of basic functions of both kidneys. In recent years, he has been fully supported by dialysis.

The donated kidney was the patient's 60-year-old, emaciated father, who had only completed the retirement procedures for a month.

Yu Zhiming knew that under normal circumstances, in kidney transplant surgery, the patient's original kidney does not need to be removed. The patient is equivalent to having an extra kidney in the body through the transplant.

Most of the transplanted kidneys are placed in the patient's right iliac fossa, connected in parallel next to the original kidney, and assume the function of the kidney.

The reason why the original kidney is not removed is because there is a very small chance that the function of the original kidney will slowly recover after a long period of recuperation.

Another possibility is that with the advancement of medicine, methods to restore kidney function have been developed.

Of course, not all kidney transplants do not require removal of the original kidney.

About [-]% of kidney transplant operations require removal of the original kidney due to factors such as inflammation and tumors.

Yu Zhiming walked into the ward while thinking about the knowledge about kidney transplant surgery and the operation process, and stood quietly by the side.

Out of the corner of Wang Jiangyue's eye, Yu Zhiming was caught.

She nodded lightly to Yu Zhiming as a greeting, and turned her attention to the patient and his father again.

"The operation time, if there are no unexpected circumstances, is estimated to take about two and a half hours."

"Do you have any questions?"

The patients, their fathers, and their family members and friends who accompanied them all shook their heads.

"Okay, let's start preparing for the surgery."

Following Wang Jiangyue's words, the attending physician, resident physician, and intern standing behind her came to the patient and the patient's father, and began to make some preparations for them before entering the operating room.

Yu Zhiming came to Wang Jiangyue's side, "Dr. Wang, thank you for giving me this opportunity to learn and practice."

Wang Jiangyue smiled lightly, "Doctor Yu, you're welcome."

"I also have to thank you for rushing here to be my surgical assistant despite a hard day's work."

"Director Cui specifically told me that Dr. Yu's surgical skills are quite skilled, no worse than those excellent surgeons in our department."

Wang Jiangyue also praised: "Doctor Yu, I am really surprised that you have both majored in internal medicine and surgery, and you are so outstanding."

Yu Zhiming said modestly: "That's Director Cui flattering me. My surgical skills are all learned in the county hospital, but I'm more proficient in performing first- and second-level minor operations."

"I haven't experienced such a big scene like a kidney transplant."

Wang Jiangyue laughed and said, "Kidney transplantation is not a big event. It is the most common operation in organ transplantation..."

"Hey, wait a minute!"

Wang Jiangyue suddenly stopped the assistants who were about to take the patient and his family members out of the ward, and looked at Yu Zhiming again.

"Doctor Yu, please give the patient's father a physical examination. He is a bit old, and his physical indicators barely meet the donation standards."

Yu Zhiming hummed, let the patient's father lie on the hospital bed, and gave him a full-body examination.

His inspection, really checked something wrong.

When Wang Jiangyue saw Yu Zhiming's expressive face full of important discoveries, she felt a thump in her heart.

It seems that this operation tonight will not be possible.

Amidst the worried eyes of everyone in the room, she called Yu Zhiming to the corridor outside and asked in a low voice.

"cancer?"

Yu Zhiming nodded and replied, "Doctor Wang, his stomach doesn't feel very good. It's very necessary to do a biopsy to confirm."

Wang Jiangyue sighed lightly, and said, "You say you don't feel well, then there is no doubt that you have gastric cancer."

"Oh, I can only find another donor..."

Human organ donation includes large organs such as kidneys, liver, heart, lungs, pancreas, and small intestine, as well as tissues such as heart valves, skin, bone, and cornea.

The medical standards for donating human organs and tissues are different.

According to my country's medical regulations, systemic or infectious diseases that pose a fatal threat to the recipient should be excluded in large organs such as the kidney and liver, including malignant tumors (excluding intracranial tumors), infectious diseases, and severe hypertension.

If a cancer patient donates a large organ, there is no small risk to the recipient.

There have been more than once in the history of medicine, such a case of organ donation that has taught people a lot of lessons.

Yu Zhiming has seen a similar case study with disastrous consequences in a medical journal.

Four patients who had received lung, left kidney, liver, and right kidney transplantation all developed breast cancer with similar histological types within sixteen months to six years after surgery.

The organs of these four recipients all came from the same donor, and the donor had no breast cancer at the time of donation.

Tragically, three of these four recipients died of metastatic breast cancer.

Only one right kidney transplant recipient survived after undergoing immunization and chemotherapy after the transplanted kidney was removed.

In later research, it was learned that the donor should have been in a very early stage of breast cancer, but it had not yet been detected.

However, through organ transplantation, the cancer cells in the body were passed on to the four recipients.

More than one case has shown that the cancer cells are too cunning, good at hiding, and suddenly stir up trouble and endanger human health.

In view of this, the organs of cancer patients must be carefully evaluated before judging whether they are usable.

In the case of the patient's father, if he is diagnosed with gastric cancer, the kidney will definitely not be transplanted to his son...

Yu Zhiming returned to the ward with Wang Jiangyue, and heard her announce that tonight's operation was cancelled, and the patient's father would undergo a comprehensive gastric examination tomorrow.

Yu Zhiming saw it on the patient's face, the undisguised disappointed expression, and the complicated gaze cast on him...

Wang Jiangyue personally sent Yu Zhiming to leave the general surgery department.

The two stopped outside the building, and Wang Jiangyue said happily, "Dr. Yu, it's fortunate that you were invited here. If the transplant operation is completed, that father will be found to have stomach cancer again."

"That's a big problem."

Yu Zhiming sighed softly, and said, "This discovery of mine will cancel the transplant operation, and patients and their families may not think it is a good thing."

"After all, getting his father's metastatic gastric cancer through a kidney transplant is only a possibility, not a certainty."

"It is not easy to find a suitable donated kidney source nowadays."

Speaking of this, Yu Zhiming is not sure if he has done a good thing.

As far as the patient's physical condition is concerned, if he cannot find a source of donated kidney in the next few months, he may not be able to persist.

As for his father's kidney transplantation, even if he was unlucky enough to get metastatic gastric cancer, with proper treatment, it is not a luxury to live another three to five years.

There is still a small possibility that you will not get metastatic gastric cancer.

Wang Jiangyue seemed to see what Yu Zhiming was thinking, and said in a deep voice: "Doctor Yu, the patients and their families are only thinking about the urgent immediate needs, not the future."

"This is drinking poison to quench thirst."

"That person has several immediate family members, besides, it may not be impossible to find other sources of donated kidneys in the next few months."

After a pause, Wang Jiangyue said again: "If one or two years later, this father and son, one with gastric cancer and one with metastatic gastric cancer, might come back to trouble our hospital."

"From the perspective of our hospital and doctors, just follow the rules and regulations, and don't take risks..."

Yu Zhiming hummed, and then asked, "Doctor Wang, how many young doctors are you leading now?"

"Three attending physicians, three residents!"

Wang Jiangyue replied, and asked with a smile: "Doctor Yu, do you have someone to recommend to me?"

Yu Zhiming smiled sheepishly and said, "I have an ordinary friend named Bao Wan, who graduated from Peking University School of Medicine, and just joined the job this year just like me."

"She is very yearning for general surgery."

"if……"

Wang Jiangyue interrupted very heartily: "A friend who can be recognized by Dr. Yu must be the same in all aspects."

"Just let her come to me directly."

Yu Zhiming quickly explained: "Doctor Wang, she and I are just ordinary friends, don't think too much about it."

"My idea is, Dr. Wang, if it's convenient for you, you can spare a little time to give her some advice and observe."

"If her ability and other aspects fall into your eyes, it would be great."

"If you don't like it, there is no need to force it."

Yu Zhiming said slowly: "I just want to ask Dr. Wang to give her a fair competition and a chance to show herself."

"If she's not strong enough, forget it."

Wang Jiangyue said seriously: "Doctor Yu, I understand what you mean."

"I'll give her a chance to investigate..."

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(End of this chapter)