The road to the rise of great doctors

Chapter 45 Thesis is ready
"Sister Li Xiao, my thesis has been written."

After discussing how to choose a mentor last night, Liu Dong was in high spirits and worked hard until 2:[-] in the morning to write the article.I was also thinking about handing the paper to Li Xiao early, so I set the alarm clock and got up early.Then he made breakfast, and when he saw Li Xiao getting up, he told her that he had sent her the paper by email.

This speed was so fast that Li Xiao frowned slightly and reminded: "You can write the paper slowly, there is no need to rush."

"I wrote an outline before, and then I couldn't sleep last night, so I perfected it based on the outline. The writing was quite smooth." Liu Dong explained simply.

"Don't underestimate the review. Although the review is a 'secondary process', the compilation, summary and outlook of a large amount of research data in the field need to be written carefully." Li Xiao paused here, feeling that Liu Dong was not serious enough, but he felt that he was not such a person, so he said, "I will take a look at it when I have time today. If there are any questions, I will tell you after reading it."

"Okay." Liu Dong nodded and said no more.

Liu Dong followed Zhu Guoliang to complete the room check in the morning, and then performed a "laparoscopic left renal cyst deroofing and decompression" operation as an assistant. The surgeon was Zhu Guoliang.

According to epidemiological data, the kidney is one of the organs most prone to cysts in the human body.Renal cystic disease is a type of disease in which single or multiple benign cysts containing fluid appear in the kidney. It is relatively common in clinical practice.The most common one is simple renal cyst.

Kidney cystic disease usually occurs when the size is relatively small and does not cause any symptoms or abnormal sensations. It is usually discovered through ultrasound examination during a physical examination or other medical treatment.Occasionally, people go to the hospital because of low back pain. At that time, the renal cyst is usually relatively large and protrudes toward the inside of the kidney, which may cause hydronephrosis and cause symptoms.

After the diagnosis of renal cysts, Bosniak classification is usually performed first when formulating a treatment plan.For patients with types Ⅰ, Ⅱ, and ⅡF, surgery is not required and close follow-up is enough.Benign simple renal cyst, type I.Of course, people with huge renal cysts can be regarded as "pathological kidneys" and are more likely to rupture when injured, so surgical treatment is also recommended, but other smaller ones do not need it.

If the patient has a renal cyst of type III or IV, surgical treatment is required.According to the latest European Urology Guidelines, Bosniak classification of renal cysts is type III. It is recommended that the treatment plan be based on localized renal cancer, because type III is more likely to be malignant. Of course, active surveillance is also one of the treatment options. Type IV renal cysts have a higher risk of malignancy, and active surveillance is no longer recommended. It is recommended to develop treatment plans based on localized renal cancer.

The patient Liu Dong participated in the surgery as an assistant had a huge renal cyst in the left kidney discovered during physical examination and ultrasound. The renal cyst had grown into the kidney and had compressed the normal tissue of the kidney. Surgery was recommended for this type of surgery.Because continued growth will affect the normal function of the kidneys.Moreover, after suffering trauma or twisting the waist slightly, the risk of this type of kidney rupture is significantly higher than that of other people.

Because the patient was young and in very good physical condition, the pre-operative examinations were completed within one day. In addition, the patient had no other special requirements, so the surgery was scheduled on the third day of hospitalization.

Liu Dong also reviewed the available treatment options for this disease before surgery. There are usually two surgical methods.

One is interventional ultrasound-guided percutaneous renal cyst puncture and drainage. To put it simply, the location of the renal cyst is located under ultrasound, and then local anesthesia is applied to the skin where the puncture is intended. After the anesthesia takes effect, the patient is Point, puncture a puncture needle and drainage tube into the renal cyst. Under the guidance of ultrasound, puncture the cyst and put the drainage tube into the cyst cavity. Then, aspirate the cyst fluid every day and inject a small amount of cystic acid to destroy the cyst wall. After the sclerosing agent is used and the liquid in the cyst cavity is almost gone, the drainage tube can be withdrawn and the puncture port can be sutured.

The advantages are clear, simple operation and less invasive.The shortcomings are also very prominent and easy to relapse.

The second method of surgery is today’s surgery, which can be performed laparoscopically or surgically.Because of laparoscopic surgery, after training and proficiency, it is very easy to perform this kind of surgery, and the field of view is much clearer than that of surgery, and the incision on the patient's skin will be much smaller, so it has become one of the most commonly used surgical methods.

The advantage is that the standard treatment plan solves the problem in one go.The disadvantages are that it requires surgery under general anesthesia, and the cost and hospital stay are longer.As a resident physician, this is one of the surgical methods that Zhu Guoliang can master, and it can also be regarded as a method that can reflect the technical level of surgery.Therefore, he still operates very seriously.And Liu Dong, relying on his familiarity with imaging and anatomy, as well as his experience in laparoscopic surgery on the kidney for many times, is also very skilled as the first assistant-the mirror holder.

Basically, there are relatively few visual fields that need to be changed. The main thing is to find a suitable viewing angle and place the area to be operated on in the center of the mirror.

Within half an hour, it was resolved.

Zhu Guoliang then carefully checked to see that there was no damage to the base of the cyst and no urine leakage. Then he checked the bleeding points and stopped the bleeding. He checked that the number of instruments and dressings were correct, and placed a drainage tube.Liu Dong now naturally took over the task of suturing the incision.

It ended smoothly.

After the operation is completed, wait for the patient to wake up from the anesthesia and return him to the ward.

Liu Dong took the opportunity to learn more about the tutors that Corey could recruit with Zhu Guoliang, then took leave of absence and left the operating room and went straight to the outpatient clinic.

After repeatedly thinking about the future development path, he finally recognized the reality.

As a doctor, if you want to go further and develop better, studying for a PhD is the only way to go.And he is also striving for the opportunity to "turn seven to eight".

Then, when choosing a supervisor, the best choice should be to directly apply for a doctoral supervisorship.

It was about which department to choose. Liu Dong thought about it for a long time, and he was somewhat inclined to choose urology.However, he still wanted to chat with interested mentors and listen to their ideas before making the final choice.The stakes were high, and he was in no rush to make a final decision.

This time, he went to the outpatient clinic and was one of the doctoral supervisors.This doctoral supervisor is not the department director or the hospital leader.

In Liu Dong's view, the department director has the most students, but he is approaching retirement and no longer takes care of the students himself. His students either go to the department to find a young master's tutor to help teach them, or they go to the Institute of Urology. Do basic research.For Liu Dong, it is not the best choice.He still hopes to grow together with his mentor, but the mentor should also have this willingness and ability.

The doctoral supervisor I want to visit this time is a new doctoral supervisor who is close to 40 years old. Although his clinical surgical skills are not outstanding, he has made great achievements in scientific research.He focuses on scientific research, and spends most of his spare time in the Institute of Urology or in the library when he completes his clinical work.
After nearly ten years of hard work in scientific research after graduating from a Ph. Attended and made academic reports at domestic academic conferences.

His name is Li Jing.

(End of this chapter)