I run a clinic in the United States

Chapter 204 Gastric esophageal replacement surgery

After the operation, Lao Jiang was sent to the ICU ward of the community hospital.Since he is Zhou Qiao's patient, he needs to come for ward rounds morning and evening every day.

Fortunately, the clinic is very close to the community hospital, so if anything happens, he can come over in time.

If something happens to a patient and he cannot find a doctor, it is the doctor's irresponsibility.For Zhou Qiao, there is no such situation.Lao Jiang will not go out until his condition is completely stabilized.

In addition, he is very confident in his own level.

Sure enough, two days later, Lao Jiang was transferred to the general ward of cardiothoracic surgery. Zhou Qiao still made rounds in the morning and evening. In addition, he sent Park Xiuzhu and Jin Jijin to come over and perform nursing work in shifts.

During Zhou Qiao's ward rounds, he asked Lao Jiang if he needed psychological counseling services from a psychiatrist. Dr. Stephanie from his clinic was very good at this.

Lao Jiang's wife immediately stopped it, because she knew that there was an extra charge for this kind of thing. Lao Jiang's character has always been strong, so there was no need for it!
Of course, there is another layer of the real reason deep in her heart, that is, she thinks Stephanie is too coquettish, like a vixen, but this is not convenient to reveal to others.

Lao Jiang is recovering day by day. However, due to the esophageal removal, he needs to inject nutrient solution through the small hole (ostomy) in his belly every day.

Stephanie also followed Zhou Qiao to check the room several times, to understand the patient's subsequent recovery, and to participate in the entire process, which greatly improved her.

She is also a medical seed. After participating in this operation, her related medical skills were immediately upgraded to a professional level.

Because she had benefited a lot, the shock and admiration in her heart was like a torrential river.

This was a cardiothoracic surgery operation. She was previously in the cardiothoracic surgery department at Johns Hopkins Hospital. Due to her short time in the hospital, she had never participated in such a difficult operation.

However, after sorting out relevant disease course information, she knew that even in a top hospital like Johns Hopkins Hospital, where experienced surgeons performed the surgery, the quality of the surgery could not be better than this.

System: "Stephanie's favorability +3, Stephanie's current favorability: 95."

……

A week later, Lao Jiang's infection was completely under control and his condition stabilized. Zhou Qiao performed the second stage of surgery on him after consulting his family members.

To be honest, gastric esophageal replacement surgery is usually used for patients with esophageal cancer. Like Lao Jiang, this surgery was necessary because a fish bone was stuck. It is really unfair.

If he had been a little alert at that time and went to the hospital immediately for treatment, since the fish bone had just been inserted and taken out in time, it would not have been delayed to the point where he needed to do this kind of surgery now!
But things have already happened, and it’s useless to say more.Zhou Qiao can only try his best to help him perform the best quality surgery!

Now that the secret medicine has been marketed, he can save on his original maximum points expenditure item.In the past few days, after hard work and accumulation, his account balance can be said to be abundant.Like before, I can perform all kinds of surgeries with perfect skills.

Anyway, once this skill is mastered, it will be useful for a lifetime.And it is done in one step, which saves more points than "upgrading" later.

The operating room of the community hospital is still the same six-person operation team as before.

Zhou Qiao is the surgeon, Murphy is the first assistant, Stephanie is the second assistant, Ava is the traveling nurse, and Elena is the equipment nurse.The anesthesiologist was senior Nancy.

Using the stomach to replace the esophagus is the most common surgical procedure chosen by patients with missing esophagus. It is usually divided into two types: one is to use a tubular stomach to replace the esophagus to reconstruct the digestive tract, and the other is to use the whole stomach to replace the esophagus to reconstruct the digestive tract.

Reconstructing the digestive tract by replacing the esophagus with the whole stomach is a relatively traditional and classic clinical treatment method. This method benefits from the sufficient length of the stomach and its rich blood supply, making it very convenient to obtain materials.

However, this method will cause serious interference to the patient's physiological structure and seriously affect the patient's quality of life.So later there was a surgical procedure to reconstruct the digestive tract by replacing the esophagus with a tubular stomach.

Anesthesia is completed and multi-person verification (time out) is completed.

Zhou Qiao starts the operation and Ava starts singing.The first song at the beginning is still a Chinese song. This is because Zhou Qiao is the boss!Although he didn't ask for it, Ava would choose some Chinese songs every time, which more or less meant this.

I have to say that these girls are quite considerate.

"Look at the early spring, the branches are bustling, the petals are in good color, and my sister is even more shy..."

Zhou Qiao thought it sounded pretty good, but he didn’t know the title of the song, so he concentrated on making a tubular stomach:

Cut off the short gastric blood vessels, left gastric blood vessels and left gastroepiploic blood vessels, while retaining the left gastroepiploic vascular arch, right gastric blood vessels and right gastroepiploic vascular arch, then separate the lesser omentum and greater omentum to the pylorus and remove them The stomach wall of the lesser curvature is about 6 cm upward from the greater curvature of the stomach. At the same time, the highest point of the stomach bottom is lifted to the lower edge of the fourth branch of the left gastric artery. Finally, the edge is sutured and the seromuscular layer is embedded.

……

Watching Zhou Qiao's operation, Stephanie suddenly thought of a question and asked: "What if some patients have a missing esophagus and most of their stomach is removed, and there is not enough stomach to replace the esophagus?"

Zhou Qiao said calmly: "You can use the colon instead of the esophagus."

That is another surgical method. The specific process is to cut off a section of intestinal tube and move it to the chest cavity as a tube. The two ends of the intestine are connected to the cervical esophagus and small intestine to replace the esophagus, completing the reconstruction of the entire digestive tract.

Stephanie and Murphy are both medical seeds, and Zhou Qiao is basically a bit more transparent, but they both feel a little disgusted when they think about it.

The colon is located in the middle and lower abdomen of the human body. It is divided into four parts: the ascending colon, the descending colon, the transverse colon, and the sigmoid colon. It is the structure of the large intestine. Everyone knows what is stored in it.

The colon is "transported" to the front of the stomach to serve as the esophagus. This... is really unacceptable to most people.

However, this is also the only solution.

Zhou Qiao looked at the two beautiful girls and knew what they were thinking. He immediately explained to them: "Using an intestinal tube to replace the esophagus is a trivial matter. This operation is actually quite complicated and has many anastomoses. It usually requires 4-5 operations." , easy to contaminate, and there are many postoperative complications, including transplanted colon necrosis, anastomotic leakage, anastomotic stenosis, etc., the incidence rate is still relatively high, so this surgery is also known as the 'Everest' of the esophageal surgery community. .”

Stephanie: "..."

Murphy: "..."

The surgery ended successfully and the results were naturally impressive.

Lao Jiang did not experience any major complications after the operation.It is estimated that if he is hospitalized for a while, he can be discharged smoothly.

For this, Lao Jiang’s family is very grateful.

It is worth mentioning that during the re-examination, Lao Jiang’s son was worried and took Lao Jiang to the University of California, San Francisco Medical Center to make an appointment with a specialist for a re-examination.

The experts concluded that Zhou Qiao's surgery was of excellent quality and he recovered well, which reassured them!
Afterwards, the expert called Zhou Qiao and told him about it.

Fortunately, Zhou Qiao is a very generous person and will not waste his energy on such trivial matters. He will just laugh it off.

Later, when Lao Jiang came to see a doctor at Iris Clinic, Ava couldn't help it and told the story. Lao Jiang was very embarrassed, saying that his son had to drag him there and there was nothing he could do.

After Xiao Jiang found out, he couldn't help but mutter, didn't he say that he wanted to protect the patient's privacy?How come you turned around and sold him?

(End of this chapter)