There are people in the court who are easy to do, and there are people in the hospital who are easy to check, not to mention the head nurse in the hospital.

The nurses and sisters are very accommodating, and after a day's work, the results of the preliminary examination came out, and stomach cancer was diagnosed!~

"What Zhang Yuan said is right, what should I do now?" The head nurse of the special needs department has no rules.

"Go find Zhang Yuan, wait. While speaking, he thought for a moment and then asked, "Do you smoke and drink in Zhangyuan?"

"I've never seen a cigarette, but I know he can't drink. I don't need ......"

The head nurse feels that they are all her colleagues, although they are superiors, Zhang Fan is usually very approachable, not that she is reluctant to send things, but as soon as she sends things, she feels a little like she is not big enough.

"What do you know! It doesn't matter if someone else does an examination, but in this situation, you listen to my ......."

People are sometimes too complicated, in fact, it is better to be simple, just when they were struggling, Zhang Fan had already seen the results of the examination from the computer.

"Director Zhao, how is it, the head nurse's mother-in-law, how is your physical assessment?"

"It's okay, the anesthesiology department said it can be anesthetized. We don't think it's a big problem on our side. Lao Zhao replied.

"Then let's get ready for surgery! I'll do it myself. ”

"Okay, Zhang Yuan. ”

Stomach, digestive tract, to be honest, in the digestive tract, the stomach is actually very leathery, just like a car in a certain country, you take good care of it, and can serve you for a lifetime.

It is not as delicate as other digestive organs. Let's talk about ulcers, in fact, among the ulcers of the digestive tract, gastric ulcers do not account for a high proportion.

Especially young people, the most common is duodenal ulcers, for example, some young people, before the meal arrives, they feel uncomfortable, their stomach is uncomfortable, eat two bites of food, okay!

This is a typical hunger pain! What can't get away is a duodenal ulcer. Also, this area is particularly prone to ulcers.

There's a reason for this, the stomach has a lot of stomach acid in it, but it has a bicarbonate barrier on its surface to protect the stomach lining.

But the intestine doesn't have such a thing, it relies on bile and pancreatic juice to neutralize stomach acid, and the gallbladder and pancreas open in the intestine together, and the fluid they secrete is alkaline.

However, there is a distance from the stomach to the opening of the pancreas, and this distance is the place where ulcers are easy to cause, which is the famous duodenal ulcer.

If you don't eat on time, you will be hungry and full, you will have to walk against the wall when you encounter a delicious meal, and if you don't like to eat, you will lose weight in the name of it.

These are all the murderers who caused duodenal ulcers.

And the stomach is not so squeamish, you eat more and eat less, and it can generally deal with it. But, when you drink and get angry, you get scared, and the most feared is Helicobacter pylori.

Cancer, simply put, is actually a qualitative change in cell quantity under an inducing factor.

Any cell in the human body has the possibility of becoming cancerous, and inflammation is the biggest inducing factor, so doctors have a saying that diseases are nothing more than two categories, either inflammation or cancer.

Helicobacter pylori, in China, is the biggest inducing factor for stomach cancer.

Some patients said, "I have never eaten barbecue, never drunk alcohol, and don't like to be angry in my life, but why did I get stomach cancer?"

As a result, the previous physical examination report showed that Helicobacter pylori was positive!

Is this bacterium contagious? Contagion, the Chinese people have a rotten problem, and when eating, especially for children, the old people love to feed their chewed food to the children.

Children eat which meals they eat at any age, eat chyle food and drink milk when they have no teeth.

If you have teeth, let him chew by himself, there is no need, let your Helicobacter pylori-rich mouth be chewed by children!

And in order to show their enthusiasm and politeness, they have to serve dishes to guests. If you have a dish, the other party can't eat it, you must watch it until the other party eats it.

This is how Helicobacter pylori is transmitted, and most of the stomach cancers in other countries are caused by other factors.

Most stomach cancers in China are caused by Helicobacter pylori.

The surgical requirements for stomach cancer are actually similar to those of stomach ulcers, and may be slightly more difficult than stomach ulcers.

Many people think that stomach ulcers don't matter, to be honest, they usually don't pay attention to it, and once an ulcer appears, it is super troublesome. Sometimes I don't have a chance to have surgery, and even if I do, it's a super big operation.

Gastric ulcer surgery and gastric cancer surgery are considered high-level surgeries in general surgery.

For example, for refractory gastric ulcer, once you have to have surgery, you generally choose to have a large gastric incision in China, what does it mean, that is, most of the stomach is cut for you, and it almost directly becomes the existence of the esophagus and intestines together.

You can think about it, the terrible sex of eating white steamed buns and swallowing them directly becomes stool, and what is even more terrible is that if you swallow half of it and then spit it out, what should you do?

All over the world, countries that can't eat enough fish to make smoked fish have a high rate of stomach cancer, such as Maruko Country and Iceland.

Although the country of pills is a relatively eccentric country, people are not more familiar with Iceland in terms of stomach cancer, even in the world, people's technology is also the boss and they are familiar with it, but Iceland is not familiar with it.

Maruki country stomach cancer is doing well, and then the endoscope is also powerful. If you think about it carefully, this country is very good at making a dojo in this kind of snail shell, and the small means are very powerful.

The head nurse looked at the two cigarettes and two bottles of wine in her hand, and said to her husband complainingly: "Why do you think people are the same as you? ”

Zhang Fan didn't hear this, because he had already taken Ma Yichen, Zhao Quanping, and Lao Song into the operating room, and if he heard this, he would probably be proud for a while.

The difficulty of gastric cancer surgery is not in the resection of the tumor, the stomach is not like the liver, the liver is like a honeycomb, and there are various vascular pathways in it......

The stomach is a flesh pouch, the blood supply is ligated, and it can be cut, and its difficulty lies in the suture and lymphatic dissection after resection.

In the operating room, Ma Yichen was making preoperative preparations, the young man was suffering, and when Zhang Fan was fighting for the liver, he was also fighting for the liver. Technology has improved rapidly, and now it feels a little emerging outside the general public.

"Zhang Yuan, Director Zhao, brush your hands!" the anesthesiologist said to Zhang Fan.

"Okay!" Zhang Fan answered, and went to brush his hands with Lao Zhao. Lao Zhao has been living a very comfortable life recently.

Because several deputy directors didn't rebel anymore, they were all frightened by Zhang Fan, not to mention the high technology, and they were so capable of liver, they all fainted with their livers, and it is estimated that there is no one left.

At the beginning of the operation, Zhang Fan was the main surgeon, Lao Zhao Yizhu, and Ma Yichen were originally the third assistants, that is, the hooks, but I don't know how he colluded with Lao Song in private, and now Lao Song has become the third assistant, and he has become the second assistant.

This kind of thing, Zhang Fan is not easy to say, he can only rely on himself whether he is enlightened.

In the tumor removal surgery, the blood vessels and the blood vessels of the stomach are ligated first, which can be said to be mainly divided into two parts.

How to say the shape of the stomach, in fact, it is a crescent, a slender person, the stomach is a thin crescent, and a short person, the stomach is mostly a fat crescent.

The inside of the crescent moon is called the small curvature of the stomach, and the outer side of the crescent moon is called the greater curvature of the stomach. The blood supply of the little bend comes from the main abdominal trunk hidden under the stomach, which is the thickest blood vessel in the abdomen, and the main artery that runs from the heart.

The blood supply to the Great Bend comes from the splenic artery on the side of the stomach.

The old lady's stomach cancer had not yet eroded the stomach body, but the area was too large, so Zhang Fan decided to have a total gastrectomy.

Zhang Fan dared to do it, there is a saying about cancer, the old, the weak, the sick and the disabled can't do it, and they generally choose palliative care.

It is not that the doctor is cruel, but that the patient is afraid of dying on the operating table.

Entering the abdomen and stretching it open, Zhang Fan began to ligate the blood vessels, and with the metal click of the pliers, the blood vessels were clamped by Zhang Fan and them.

The only thing that is a little troublesome is that the blood vessels in the stomach are all dressed in yellow coats, that is, they are all hidden in the omentum.

What is the omentum, yellow fat, it's opaque, it's not stockings. "It should be noted here that no matter how sure you are, you must see it with your own eyes and touch it with your own hands before you can clamp it. ”

While Zhang Fan was doing it, he told Ma Yichen the key points.

"Hmm!" Ma Yichen listened very seriously.

Passers-by pulled the hook doctor Lao Song, envious of the dead, he had nothing to do, and he couldn't do anything, because he couldn't see the surgical field, this operation was just with his hands, and there was no need to bring brains.

"Hey, pony, I've met such a good teacher! ”

Lao Song is not very old, but he is very embarrassed, seven or eight years younger than the deputy directors, and when he entered the department, it was just when the deputy directors were rushing to practice.

So, he has been an appendix for many years. At the age of long technology, there is no chance, and in the end, the upper limit is not high.

The blood vessels were ligated, the ligaments hanging from the stomach were separated, and most of the abdominal organs were fixed with ligaments.

Without this ligament, people can't do strenuous exercise, otherwise a fluctuation and the kidneys may be able to ...... from the urethra And fall out.

After separation, the esophagus and intestines connected to the stomach are clamped, "knife!" Zhang Fan said to the instrument nurse.

Scalpel, Zhang Fan, who was holding the scalpel, directly cut off the stomach from the esophagus and intestines along the edge of the forceps, and then Zhang Fan reached out with both hands, just like holding a watermelon, and took the stomach out of the abdominal cavity.

At this time, looking out of the shadowless lamp, the abdominal cavity became a large hole, and the lonely spleen on the right side and the large blood vessels below were all revealed.

Zhang Fan's level of general surgery can no longer be underestimated, and if the surgical field is described by an adjective, it is clean! Yes, it is clean.

There is almost no blood to be seen, as if you were using a knife on a rubber doll, this is the level.

Some doctors don't pay attention to small blood vessels, but if there are more small blood vessels, there are large blood vessels, and after an operation, it is like a broken ketchup bottle, not to mention the patient, even he himself is dyed into a red ball.

That's it, he's still proud! Lao Tzu has surgery! I don't know, I think he killed pigs.

Lao Zhao admires Zhang Fan's level very much, and in Zhang Fan's free time when he takes out his stomach.

He said: "Zhang Yuan's surgery is like art, and the cleanliness of this surgical field is perfect. ”

But I didn't talk much, because the difficulty of surgery came, the difficulty of cancer surgery, where is the difficulty?

It can be said that lymph is like yellow sesame seeds sprinkled near the blood vessels. When there are many of them, there are seven or eight or so of them gathered together, and when there are few of them, there are three or four.

Cancer surgery is all about cleanliness, because many cancers metastasize are lymphatic.

In order for the patient to live a few more years, the lymph must be cleaned. It's all hidden in fat.

And not to mention hidden in fat, it also relies on blood vessels to clean lymph, which is not only slow, but also dangerous.

This thing is either lying on its stomach at a large blood vessel, or hiding near a large blood vessel.

It is estimated that it is not dangerous to pick with a needle during cleaning, but it is estimated that when the needle is finished, the patient will hang up because it has taken too long.

It is to use a curette, a magnified ear picker, and scrape along the large blood vessels one by one.

How dangerous it is, in this way, not to mention the large blood vessels such as celiac trunk, the small celiac artery is a fatal thing.

This artery is like a snake's head, once it bursts, not to mention the blood, its powerful muscles will retract, which is particularly difficult to serve.

Zhang Fan began to take a curette and began to dig around the abdominal trunk.

This force should be quite stable, it can't be scraped off lightly, it can't be scraped cleanly, and the operation is done in vain. If it is heavy, the blood vessels will be scratched, and the operation will be done in vain.

Zhang Fan scraped very quickly, and the patient was too old for her to last long. Zhang Fan must be fast.

Crash!

Crash!

Zhang Fan scraped it down one by one, just as fast as a greedy fat man digging ice cream.

Not to mention Ma Yichen, Lao Zhao clenched his hands into fists. It's terrifying. The metal curette is visible to the naked eye to do things on the thick abdominal cavity, and Zhang Fan is faster than the other.

Lao Zhao, who was in a cold sweat, couldn't help but look at Zhang Fan, although he saw that Zhang Fan looked very concerned, but he was still worried.

Because Zhang Fan's operation was too fast, he had never seen anyone with such a fast technique.

He wanted to persuade, but looking at Zhang Fan on the abdominal cavity one by one, he didn't dare to say anything.

He was deeply afraid that he would interfere with Zhang Fan.

"It's going to be a hell, it's going to be a hell!" Lao Zhao's hands trembled a little.

As the second assistant, Ma Yichen was excited.

He was shouting in his heart, "This is called technology, this is called technology, handsome!"

Newborn calves are not afraid of tigers, although he knows the danger of surgery, but Zhang Fan's hand is too handsome.

"I don't know when I'll learn to do this!"

Zhang Fan's hand was too steady.

After cleaning the lymph, inside the curved plate, it is like a plate of yellow cream with strawberry juice ice cream, and even the small particles on the surface of the strawberries, red is blood, and small particles are lymph, which is too TM and looks like it.

After cleaning, Zhang Fan confirmed it again, and then began to stitch it again, what was stitched?

Suture the esophagus and place it on the small intestine.

The esophagus has no outer coat because it is not like the intestines, which are crowded together and peristalsis, so it does not have a serous layer.

The esophagus does not move freely, so what does it rely on to clean up the esophageal residue, it depends on saliva, some people like to spit when they are fine, don't spit out, and if they vomit again, the esophagus will be sick.

Without this coat, it is very troublesome to stitch, directly in the bare muscles.

At this time, the muscles are like wires without insulating pipes, and the steel wires inside are scattered.

This suture, a doctor with poor skills, let alone let the esophagus be sewn on the intestine, don't stitch the esophagus is not bad.

"Line 0! Open the absorbable line of the inlet. Zhang Fan said a word of nonsense about the equipment.

This line is more expensive than the domestic one, a difference of more than ten times, but this line is really easy to use.

Layer by layer of stitches, the threads flew in Zhang Fan's operation, and the esophagus and intestines were stitched too beautifully. It's just like they grew together, and it can't be seen that it's a secondary suture.

After suturing, the elevated duodenum must be fixed, because the stomach is missing, if the duodenum is not fixed.

Which is terrible, maybe a shout, pull as one, the intestines are pulled off, and then a section of blood is spit out of the mouth Hula intestines.

Six hours later, Zhang Fan and the others finally finished the total gastrectomy operation. After the sutures closed the abdominal cavity, the matter was not over, Zhang Fan took the knife and was about to attack the severed stomach.

At this time, due to the lack of blood, the temperature has been lost, and the fat on the surface of the stomach has been moistened, if it is steaming, it is directly like the foie gras in the pork belly of the French meal.

Scratching the stomach, the tumor inside is exposed, just like the heterosexual hive in the movie, the surface is blood vessels, and the inside is rotten like yellow thick phlegm.

"Take it to the family and see it, and then do a medical examination!"

"Good. ”