After experiencing such a heavy experience, the four of them were in no mood to eat any more, especially when Yi Sheng said the sentence "That is to say, the liquid that bursts is actually aqueous humor, and the crunchy one is the lens", Hao Zhe spent the whole night holding the toilet.

Today is the daily case discussion of neurosurgery. Every week, the attending physicians in charge of the three wards will make a systematic discussion of the patient's condition for a week, and select more representative cases for discussion, so as to eliminate the gap and make up for the shortcomings. At the same time, today Professor Li Shangai will also come up with a surgical treatment plan for Liang Susu brainstem glioma.

After the end of the daily rounds, all the doctors in the neurosurgical oncology unit came to the conference room, including Liang Susu's mother Pan Yun, and everyone was beating drums in their hearts, after all, it was a bit hasty to come up with a surgical treatment plan in such a short time.

Glancing at the schedule of the operating room, Yi Sheng had a subdural hematoma operation performed by Meng Xianyang in the afternoon, and the nurse on duty told him that he didn't have to go to the conference room this morning, and his task was to accompany Liang Susu in the ward.

Although there are also itinerant nurses in the ward, itinerant nurses can't always stay in Liang Susu's ward, so this heavy responsibility is on Yi Sheng's shoulders.

"Susu, do you want to eat some fruit?" Yi Sheng helped Liang Susu tuck the quilt and sat down beside her and asked.

Liang Susu is now weaker than when Yi Sheng first saw her, her whole body is full of leads from various instruments, and she needs a ventilator to help her breathe at night to prevent apnea while she sleeps.

"Brother, if you tell me the truth, will I die?" Liang Susu's voice was no longer hoarse, but replaced by weakness, incomparably weak.

"How could Su Su die?" Yi Sheng comforted Liang Susu as he sorted out the messy bangs: "Su Su is just a little sick, your Uncle Meng and the new Director Li are discussing your treatment plan, I believe they will soon be able to come up with a good plan, and then Su Su will be able to live a normal life like other peers." ”

"Liar," Su Su took a few breaths and said: "Although you all say that I am not seriously ill, but I am not a fool, you can deceive me, my mother can't deceive me, since I came to the hospital, my mother's eyes have always been red, and ..... And her hair is gray ... I've heard people say that people only turn white overnight when they're sad, and since my dad left, my mom has been the only one left, so... So..."

"Don't think nonsense," Yi Sheng tried his best to keep the smile on his face and said: "Su Su, the only thing you need to do now is to cultivate your spirit, Aunt Pan is just your daughter, God will not let you leave your mother so early, believe in your mother, and believe in us, we will definitely do our best to cure your illness." ”

At the same time, in the conference room, everyone's eyes were focused on Li Shangai, who projected the treatment plan he had been thinking about for the past few days on the big screen.

"Ms. Pan's daughter, Liang Susu, has a brainstem glioma that straddles the pons and midbrain, and judging from Liang Susu's current symptoms," Li Shangai explained, pointing to the big screen, "The tumor compressed the vestibulocochlear tract and the somatic motor fibers of the vagus nerve. Whether the tumor compressed the seven arteries of the midbrain is still up for debate. ”

"Professor Li, we have discussed these cases in detail in the previous case discussion, and now the problem is how to perform the surgery and ensure the quality of the surgery. Meng Xianyang leaned on his seat and reminded the authentic.

Li Shangai turned to the next slide and turned to Meng Xianyang and said, "Director Meng, as the chief physician of neurosurgery, should have heard of cavernous hemangioma, right?"

The so-called layman looks at the liveliness, and the insider looks at the doorway. As soon as Li Shangai's words came out, Meng Xianyang couldn't help but sit up straight, frowned and said, "Cavernous hemangioma is within the scope of my department, of course I have heard of it. ”

Li Shangai said happily: "I think Director Meng's previous case discussions must have revolved around the issue of this surgical pathway. In general, dorsal pontine tumors and midbrain parietal tumors should be treated with the posterior median transcerebellar bulbar fissure transmedullary sail approach and the suboccipital transcerebellar tentorial or subtentorial transcerebellar approach, respectively. However, if the two surgical pathways are performed at the same time, the difficulty of the operation will be greatly increased due to the narrow operation space, and the risk of surgery will also be increased. ”

"Professor Li means that you want to use the inferior temporal transtentorial approach commonly used for cavernous hemangioma?" Meng Xianyang reacted and blurted out: "But if you choose the inferior temporal transtentorial approach, how to choose the brainstem safety area?"

"The anterior midbrain region was removed into the superior trigeminal nerve region. Li Shangai explained: "At present, the research on the surgical approach and safety area of the brainstem is mainly based on the study of cavernous hemangioma, because the main effect of cavernous hemangioma is the pushing effect on the brainstem, and the destructive effect is secondary, and for the low-grade brainstem tumors in the leonsu brain, the effect is mainly the pushing effect on the brainstem, and the destructive effect is secondary, so although the glioma is an intracerebral lesion, the low-grade glioma is also applicable to the research approach and safety area." ”

"Liang Susu's tumor is located in the midbrain and pons. Midbrain tumors involve anterior, middle, posterior, and lateral tumors, especially the lateral and posterior protrusions, and push the brainstem to the opposite side. The pontine tumor involves the posterior and lateral parts, especially the lateral protrusion, and pushes the brainstem to the opposite side, while there is still some normal brain tissue in front of the pontine tumor. In addition, according to the T2 image of the MRI, although the tumor is as low as the lower 1/3 of the middle pontine brain, it is soft and can be pulled upwards to remove it. Therefore, I think that the surgical approach of Liang Susu should focus on the design of the surgical approach from the outside, and consider the use of the inferior temporal approach. Due to the lesion of the pons region, the inferior temporal transtentorial approach is preferred. Li Shangai said: "This is also the most suitable and safest surgical path for Liang Susu I can think of." ”

"Director, I have a question!" He Zhen, the new chief neurosurgeon, raised his hand and asked: "Although the surgical resection path you chose for cavernous hemangioma can indeed be applied to the operation with Liang Susu, according to the domestic brainstem anatomy experience, the design scheme you chose may also involve the lateral midbrain sulcus and the para-trigeminal nerve area, why not use these two safety areas?"

"That's right," Li Shangai nodded and said, "Although the 6th in the para-trigeminal nerve area, The descending microscope of the 7 and 8 pairs of cranial nerves all walk behind the trigeminal nerve nucleus and will not cause damage during the operation, but the average distance between the trigeminal nerve and the corticospinal tract measured according to the axial position is only 4.64mm, and the average distance to the deep trigeminal nerve nucleus is 11.2mm. As for the lateral sulcus of the midbrain, it is relative to the selection of the supratrigeminal region. ”

Although Pan Yun was completely foggy by Li Shangai, but seeing the other doctors nodding their heads, it should be Professor Li's plan that worked, so he quickly stood up and said, "Director Li, since the surgical plan has been determined, will the operation be carried out soon?"

"Ms. Pan Yun, don't worry. Li Shangai's face was embarrassed, he took off his glasses and sighed: "Although the surgical plan is confirmed, I can't perform the operation." ”

"Expected. Meng Xianyang gently turned the pen in his hand and sighed secretly. How could he not see the feasibility of the plan? But after all, Li Shang-ai is just a theoretician engaged in theoretical research, and if you let him really do it, he may not be able to catch up with Yi Sheng, a new intern.

"Why?" Pan Yun was puzzled, seeing that his daughter might be cured soon, how could Pan Yun not be excited, but Li Shangai's words made Pan Yun fall from heaven to hell all of a sudden.

"I can indeed come up with a feasible plan, but I am a theoretical researcher, and practical hands-on operation is not what I am good at. Lee Sang-ae explained.

"Director Meng, I want to hear your thoughts. Li Shangai raised his head and looked at Meng Xianyang and said.

Meng Xianyang didn't expect Li Shangai to push the main operation to himself. As a doctor, he knows exactly what a unique surgical treatment plan means, and as long as the surgery is successful, the surgical process will be discussed and then published on the medical website, and he will win himself countless accolades.

"I think this plan is feasible, but ......"

"Director Meng, don't do it.... Su Su's physical condition is getting worse and worse now, and she can't wait for you to discuss a perfect surgical plan. Pan Yun interrupted Meng Xianyang's words and said anxiously.

Meng Xianyang hurriedly explained: "Ms. Pan Yun, it's not that I don't want to do this surgery, it's that I really don't have the confidence to do it. ”

Although Meng Xianyang has many successful experiences in brainstem tumor surgery, this treatment plan was not thought up by Meng Xianyang, just like although Mr. Tang Jinbo founded the soup suture method for hand surgery tendon suture, there are not many doctors in China who can skillfully apply the soup suture method, for this operation, for the treatment method proposed by Li Shangai, Meng Xianyang has not tried it before, so he is not sure to ensure the safety of Liang Susu's life during the operation.

In the case of uncertainty, Meng Xianyang will definitely not do this operation, if Liang Susu dies on the operating table, it is not called treatment, but murder.