A new day.

Kong Dexing, vice president of the Affiliated Hospital of Jiang Medical College, walked into the operating room of the hospital in high spirits.

Today, there is an important operation that must be performed by him.

The patient was a relative of Director Gong of the Department of Nephrology of our hospital, and his disease was retroperitoneal tumor.

The posterior peritoneum is deep, and because of the large abdominal cavity, the mass effect at the initial onset of the tumor is not obvious. The clinical symptoms are also mostly soreness in the lower back, which is often mistaken for low back muscle strain and delays the condition.

Director Gong's relative is a woman, who only celebrated her thirtieth birthday in September last year, and has obviously felt that her belly has become bigger in the past two months.

As a last resort, I came to the Affiliated Hospital of Jiang Medical College and found Director Gong.

The diagnosis is very simple, after a B-ultrasound examination has been done, the cause is clear, but whether the retroperitoneal tumor is benign or malignant is not something that can be judged by B-ultrasound.

However, whether good or bad, the first treatment for this disease is, of course, surgical excision.

So, Director Gong took his relatives to find Vice President Kong.

retroperitoneal tumors...... Well, it is much more difficult to operate than intra-abdominal tumors, but for me, Vice President Kong, it is not a big problem.

After arranging for the patient to have a further abdominal CT examination, Kong Dexing took the film and looked at it carefully, and then easily made a judgment and accepted the patient.

Vice President Kong's ability to read CT films is still quite in place, but the imaging examination results cannot accurately reflect the true condition of the lesion.

Vice President Kong also fully considered this point before the operation.

He did not entrust the university, but organized three MDTs before the operation, involving spine surgery, gastrointestinal surgery, vascular surgery and urology in addition to his hepatobiliary surgery.

Based on the opinions of experts in various departments, the surgical plan was revised several times, and the surgery has been performed on stage until today.

Smooth laparotomy, free abdominal organs, and exposure of the posterior peritoneum.

The posterior peritoneum was opened, and the biopsy was sent to the pathology department for rapid intraoperative pathological diagnosis, and then the surgical field was expanded to explore the scope of tumor invasion.

Kong Dexing's expression gradually became solemn.

If the preoperative assessment of the difficulty of the operation was 7 to 8 on a 10-point scale, it now seems that it has exceeded 10, and it seems to be increasing as the exploration progresses.

The tumor is not a single tumor, but dozens of tumours are adhered together, making the CT image misleading.

The entire retroperitoneal space is filled by the tumor, including the roots of the upper and lower mesenteric arteries, the roots of the celiac trunk of the aorta, the roots of the renal arteries and veins, and other important blood vessels, all of which are encapsulated by the tumor.

Cut, can still be cut.

But want to cut clean......

Kong Dexing couldn't help shaking his head on the operating table.

If there is a surgical robot, then it may be possible to cut it clean with a little more time, but if it is a manual operation, I am afraid that it will ......

Kong Dexing's mind suddenly popped up with a person's name.

Yang Xi!

I'm afraid that only Yang Xi, the demon, can do it.

Thinking of Yang Xi, Kong Dexing couldn't help but feel a burst of liver fire. More than two months ago, the live broadcast of the regular training doctor skills competition unconsciously surfaced in front of me.

It's no wonder that Senior Brother Qin would treat him like that, this bastard thing is really hateful, in his heart, there is no respect for the seniors, the teachers, and the elders, as long as it is beneficial to him, as long as it can satisfy his vanity, anyone can be trampled under his feet, and he will not give any face.

Today, if he begged that bastard in front of that bastard because of this operation, how would he humiliate my old hole?

Forget it.

It was humiliating enough last time in that live match, and this time, you must not take the initiative to give that bastard a chance again!

Twenty minutes later, the pathology department sent a diagnostic report, ganglion cell neurofibroma.

Konde Hinden had a big head.

Retroperitoneal tumors are mostly malignant, especially in cases like the one on the stage that showed symptoms of rapid tumor enlargement. In the case of malignant tumors, the prognosis of patients is not greatly affected by clean and unclean cuts.

Malignant tumors such as those located in the posterior peritoneum, the so-called clean cut, are only visible to the naked eye of the surgeon, but in fact, there are still a lot of tumor cells left in the posterior peritoneal space. Therefore, as long as appropriate chemotherapy and radiotherapy are given after surgery, there is almost no difference in the survival rate of patients.

However, this gangliocytic neurofibroma is a benign tumor.

If it is simply benign, there is no need to worry about whether it is clean, but it is not a simple benign tumor, because if the tumor has symptoms of rapid enlargement, then it is very likely to have malignant transformation.

Such a pathological process, whether it is cut clean or not, can mostly go to the prognosis of the patient.

If the cut is clean, there is no need for chemotherapy after surgery, only a supplementary radiotherapy is needed, then the patient is likely to get a curative result, and it is not the cure as the doctor understands, but the recovery that the patient expects, and there will be no recurrence for 10, 20, or even longer.

But if it is not clean, it cannot be said to be a failed operation, but at least it is a less perfect operation. No matter what kind of chemoradiotherapy regimen the patient is given after surgery, the likelihood of recurrence is much greater than that of the former.

The doctor is benevolent, but he must also have a conscience.

Kong Dexing hesitated for two or three minutes, first gave up the idea of partial resection, and then vetoed the idea of resigning from the position of Guan Dang and proposing to transfer to the hospital.

Please Yang Xi!

As long as he can do this operation well and give the patient the best result, my old face of Kong Dexing can be trampled on by him!

When making this decision, Kong Dexing did not consider the factor of entering the Department of Nephrology Director Gong at all.

Stepping down from the operating table, Kong Dexing called the patient's relatives through the video phone in the operating room.

After explaining the situation, the patient's relatives asked Vice President Kong to wait a little, they did not understand medicine and needed Director Gong to come and call the shots.

Only then did Kong Dexing think that this patient was still an acquaintance in the hospital.

Ten minutes later, Director Gong hurried to the operating room.

Kong Dexing brought Director Gong to the operating table, asked the assistant to expose the surgical field, and explained: "Dozens of lumps were condensed into a lump, and the upper and lower mesenteric arteries, renal arteries and veins, and abdominal aortic trunks were all encapsulated. If you want to cut it clean, the risk is too great, but if it is palliative excision, the prognosis of the patient is not very good. ”

Director Gong said nervously: "What do you mean by the Confucius Institute...... Why don't you transfer to the magic capital?"

Kong Dexing shook his head and said, "Over there in the magic capital, Professor Chen has a surgical robot, but he can cut it clean, but go to his side, how long will you have to queue up?"