The road to the rise of great doctors

Chapter 57

Gynecological surgery is difficult to say and easy to say.

On a new day, Liu Dong finished processing the doctor's orders and checking the room, and quickly rushed to the operating room. When the door of the operating room opened, he found that Director Zhang of his group had already started the operation alone.

When he finished brushing and disinfecting his hands, put on his surgical gown, and stood beside the operating table, a hook was handed over.He pulled the hook and glanced at the operating field, and saw Director Zhang holding the electric knife in one hand and the organs in the other, "squeaking" apart, and in less than 2 minutes, he removed the side with the tumor. Found it out.

Liu Dong pulled the hook and picked up the suction device, trying his best to do Isuke's work, also in order to see more clearly.

I saw that Director Zhang did not continue with other actions, but began to explore and check the situation inside the stomach. I found that the appendage mass was adhered to the surrounding tissue, and the boundary was unclear.Director Zhang cut off the attachment on this side and sent a quick pathology test to the pathology department for examination to determine what the tumor was.

About 10 minutes after arriving, the circulating nurse brought over the pathology report and read it loudly to everyone, "Serous cystadenocarcinoma of the right ovary."

"Alas!" Director Zhang sighed. At this time, the head doctor also finished handling the work in the ward and came to the operating room.

She was shocked to find that her leader, the respected Director Zhang, had cut off the appendage tumor and the pathology had returned. The nickname did not deceive people, and the "quick knife man" lived up to his reputation.She quickly washed her hands, dressed, and went on stage.

Director Zhang said, "There is metastasis. Now we are starting to explore the pelvic cavity. There are also cauliflower-like tumors on the surface of the appendage on the other side. There are many large and small masses scattered in various places in the pelvic cavity, peritoneum, small intestine and colon surface. Surgery is required. All areas with tumors should be cut out, and any swollen lymph nodes suspected of metastasis should also be cut out and cleaned."

In 15 minutes, the main steps were completed, including stopping bleeding, placing drainage tubes, and checking the dressings with the nurse.

Liu Dong could see that the main reason was that Director Zhang still had the awareness to teach. After Dr. Zong came on stage, Director Zhang's movements became much softer, slower, and more meticulous.And Liu Dong also had a "teaching video"-style surgical demonstration.

"Okay, you two finish up. I'll leave the rest to you. I'll go take a look at the family members."

After Director Zhang finished speaking, he took off his surgical gown and walked towards the talking room in the operating room with the cut organs and tissues.

Doctor Zong and Liu Dong were left looking at each other.If you follow such a leader, you have to compete with him for speed.

As soon as Dr. Zong was about to start, he saw Liu Dong skillfully closing the abdomen, suturing, tying knots, and cutting threads.The movements are clean and neat, without a trace of excess.

Dr. Zong had an inexplicable feeling that he was redundant.

Watching Liu Dong quickly complete the work of closing the abdomen and suturing the subcutaneous and skin.Then apply the dressing.He did nothing, and then he could step down.

"Xiao Liu, right? You took the postgraduate entrance examination after working?" Dr. Zong asked.

Liu Dong shook his head and said, "Mr. Zong, I am a seven-year clinical medicine major in the medical school. I was led by teachers from the Department of Urology and Emergency Surgery, so I am familiar with all these tasks."

Doctor Zong nodded.

Liu Dong understood that his basic skills were pretty good and could reach the level of an attending doctor.But compared with Director Zhang, it seems nothing.

Director Zhang's efficiency and familiarity in performing surgeries fully illustrate the enviable skill of "practice makes perfect".This is a patient with ovarian tumors.

Ovarian tumor is a very common gynecological tumor, which can occur in women at any age. It is more common in middle-aged and elderly people, and it is rare for people before minors.However, since there are no symptoms at the time of early lesions, it is rarely found except for physical examination ultrasonography.And once you see a doctor because of symptoms, most of them are already in the advanced stage, so the fatality rate of this disease ranks first among gynecological malignancies.

The 51-year-old man who just completed the operation today came to the hospital because his lower belly had become enlarged and he felt uncomfortable with distension.After arriving at the hospital, I did an ultrasound and found that it was an ovarian problem, so I went to the gynecology clinic. The doctor at the clinic was Director Zhang.At that time, when the patient saw that it was a male doctor, he did not want to see him and wanted to find a female doctor.

As a result, only Director Zhang was out of the clinic that weekend.

After reading the report, Director Zhang knew clearly. He asked the patient to do a urine test, and then called the woman's daughter over. In a few simple words, he introduced the diagnosis and treatment plan. He had to be hospitalized!

The daughter's eyes couldn't help but become moist. She glanced outside and saw that her mother hadn't come back yet. She started crying without restraining her emotions.While crying, he looked outside.After two or three minutes, I stopped my emotions, wiped away my tears, and pretended to be calm, waiting for my mother to come back.

Then, I was hospitalized for an examination, and there was no contraindication to surgery, so I could arrange surgery.

Enhanced computed tomography scans of the chest, abdomen, and pelvis were performed to clearly diagnose the scope of the disease. Except for an adnexal mass on one side, no other parts were found.

The clinical diagnosis is basically clear, but the specific pathological type and confirmed diagnosis still require surgery and post-operative histopathological examination results.

So there was the surgery just now, so fast
Postoperative pathology results confirmed that both ovaries were high-grade serous adenocarcinoma.This is also the most common type of epithelial ovarian cancer.

After the patient wakes up, he is returned to the ward.

Liu Dong and Dr. Zong were waiting in the operating room, waiting for the arrival of the next person.

This is how it is on surgery day. A group of patients in one group undergo surgery one after another, so the rounds will connect very quickly.

"Teacher Zong, this person has terminal cancer, right? Now that the operation is completed, is there anything else that needs to be done later?"

"The general principle of initial treatment for ovarian epithelial cancer is surgery as the mainstay, combined with comprehensive treatment such as chemotherapy and radiotherapy." Dr. Zong replied.

"For some cancers, if there is abdominal metastasis, most of them will not undergo surgery and start chemotherapy or targeted therapy directly. But this disease is different. As long as the patient can tolerate surgery, no matter the size of the tumor, no matter whether there is abdominal metastasis or not, , they all undergo surgery first.”

Liu Dong became a little curious and asked, "Why? Surgery after transfer can only be regarded as a palliative surgery, not a radical surgery. What's the use?"

"It still has a great effect. It can make a clearer diagnosis, whether it is histological type or surgical pathological staging. In addition, it is also a way to remove cancer cells to the greatest extent. It can also remove or reduce the complications caused by this disease. "

"Of course, in addition to surgery, postoperative chemotherapy is also required."

"Well, if early cancer screening can be implemented, it may be detected at an earlier stage. Many people who come to see a doctor because of symptoms have late-stage cancer when they are first diagnosed. For late-stage cancer, it is difficult to remove all the lesions with surgery. So, chemotherapy is part of the first treatment for the vast majority of these patients."

(End of this chapter)