The old lady had a cervicothoracic junction with a huge tumor.

According to the diagnosis, it is more than ten years old.

It's hard to imagine how she could live under the torture of illness.

Mediastinal tumor is a common clinical thoracic disease, with blurred boundaries and incomplete capsule, which has strong ability to spread and metastasize.

Because the location is relatively special, it is a ceiling-level difficulty outside the chest.

Most mediastinal tumors are benign, but some are malignant.

After puncture, it was understood that the tumor was malignant, and it was really a house leak that happened to rain overnight.

From the imaging, the tumor has grown diffusely, compressing the lung tissue and the superior vena cava from the heart.

The patient usually has a hard time breathing and eating.

As for the upper vena cava being pressed by the tumor, it is difficult for the upper body to return blood, and the old lady also has severe edema on her face.

If the lips are blue and the central venous pressure exceeds 30 cm H2O, this is a severe superior vena cava syndrome!

Choosing the best entry diameter as an incision requires a lot of experience!

Also, how is anesthesia induced to complete the intubation?

How can nerve damage be prevented during complete tumor removal?

There are a lot of difficulties like this.

Even in the affiliated hospital with many masters, it is quite a headache.

When Zhao Yuan first saw this case, he was also a big head.

I did a lot of thinking and finally decided on the plan!

Zhou Guangchen is very confident in Zhao Yuan.

Although it is a surgery that has never been done before, with Zhao Yuan's familiarity with the chest structure and the control of the basic skills of surgery, there should still be a way to do the operation well.

At the beginning of the operation, Zhao Yuan took into account the age of the patient and treated it with minimally invasive techniques.

choose

3 small incisions under the xiphoid process will not cause great trauma.

Jealousy is stronger where there are more elites.

Many people look at the operation with a learning mentality, and some people viciously hope that Zhao Yuan will sink into the sand.

"The incision arc is very small, and there is basically no bleeding. The amount of blood in the suction device is definitely not more than 20mL, which is a bit scary. ”

It is important to know that patients sweat more than that.

"The action is not very fast, but there is basically no superfluous action."

"I don't even use a locator."

"A lot of auxiliary equipment is useless."

"It's too big! Is it to deliberately be handsome? ”

"People have confidence, what are you anxious about?"

Shang Yu has always disliked communicating with colleagues, but at this moment, she couldn't control her emotions.

If your ability is not as good as others, are you also blind?

The quality of the technology is obvious, Zhao Yuan's level completely beats so many people present, why bother to open his eyes and talk nonsense?

Is it so hard to admit that others are excellent?

"Xiao Shang, don't be angry, we're just chatting."

"Okay, let's say less. The small merchant has a relationship with the main knife. ”

Several doctors finished sarcastically and sarcastically, and then stopped commenting on Zhao Yuan.

Although they didn't take Shang Yu seriously, they knew that Shang Yu was Zhou Guangchen's assistant, and offending Shang Yu had the risk of provoking Zhou Guangchen, so there was no need for that.

The huge tumor was exposed to the field of vision, and the tumor with the longest diameter of up to 10 cm occupied the entire anterior mediastinal region of the patient, severely invading the superior vena cava and trachea, and closely fitting with the surrounding nerves, blood vessels and other tissues.

"This ...... It's a bit too exaggerated, the vena cava is almost closed by compression. ”

Zhao Yuan took a deep breath.

difficult

The degree has increased more than expected.

The original surgical protocol needs to be adjusted.

"Zhou Hospital, according to the plan, re-bypass the blood vessels that return to the superior vena cava, and restore the original hemodynamic characteristics as much as possible."

"Roger!"

Zhou Guangchen was also taken aback when he saw the situation in the cavity.

Although the patient's condition was prepared for the worst before the operation.

However, tumor surgery is really a blind box, and only the moment you open it, do you know how to deal with it.

"It's over, it's terrible inside. The incision is smaller! ”

"Can such a large tumor be removed through three minimally invasive incisions?"

"What now? Do you want to make a new incision? ”

A few colleagues who had said bad things about Zhao Yuan in a weird way before secretly glanced at Shang Yu.

Although he was particularly worried, he could not hide his schadenfreude.

Some words are not spoken, but the meaning is already expressed.

- What a bullshit genius, the cut was wrong at the beginning.

Zhao Yuan has already made the worst assessment!

Although the situation inside the cavity is bad, it is still within his judgment.

If you are a general doctor, you will have to make a new incision at this time, and even cardiopulmonary bypass support.

But Zhao Yuan still chose minimally invasive resection of the tumor.

Because he has this certainty.

Zhou Guangchen's scalp was a little numb.

He knew that Zhao Yuan's level was very high, but it was obviously beyond his own assessment!

"Knives!"

Zhao Yuan asked the instrument nurse for a scalpel.

Directly into the cavity.

The blade slashed, cut, pointed, cut, like a sympathetic field veteran, gently bit his girlfriend's lip with his teeth, taking away the shallow lipstick, and did not even touch the lip skin.

The master just can't do it in the most critical part

Damn thing.

The limit of stripping is to frantically test the edge of touching and not touching.

No more, no less. If you cut too much tumor, it will hurt the tissue, and if you cut less, it will recur.

Zhou Guangchen felt that he was back in his student days, and kept asking himself what he should do if he did it.

The surgery is getting faster and faster!

At this time, the second assistant and the third assistant realized what a master was, Zhao Yuan and Zhou Yuan were like drag racing, frantically stepping on the accelerator.

Speed, precision, anticipation!

However, they obviously felt that Zhou Yuan was chasing Zhao Yuan, and they were a little struggling.

Zhao Yuan didn't expect that his surgical rhythm would be brought up by Zhou Guangchen.

He usually doesn't do surgery so quickly, but today with Zhou Guangchen to catch up, he unconsciously increased his speed.

glanced back at Zhou Guangchen and found that there was a touch of unwillingness and firmness in his eyes.

Zhao Yuan hurriedly adjusted the rhythm.

The rhythm of the chief surgeon decreased, and the speed of Ichisuke naturally decreased.

Zhou Guangchen secretly sighed that Zhao Yuan's subordinates were merciful, if they were to pull for another ten minutes according to the strength of Fang Cai, they would have to burst the cylinder, and it would be ugly.

This level of surgery is really hard to see in normal times.

Usually, most surgeries are not performed at such a fast pace.

Although the regulations of the operating room clearly stipulate that it is not allowed to make noise in the operating room, there will still be intraoperative chats, and despite wearing masks, people will have droplets when they talk, which violates sterility regulations.

However, at a certain level, there is basically no verbal communication during the operation.

Even when the main knife gives instructions, it will be particularly clean and neat.

The second assistant and the third assistant are both chief physicians of thoracic and cardiac surgery, and one of them once also gave a class to Zhao Yuan, but now he found that he is

It is very difficult to interpret Zhao Yuan's technique.

Although their level has not yet reached the level of Zhou Guangchen, they are definitely excellent young doctors, and if they go to the prefecture-level city, they are definitely masters.

However, they were not so lucky today and met a genius.

However, they didn't feel uncomfortable in their hearts, after all, Zhou Yuan was a little tired under Zhao Yuan's rhythm.

After 5 hours of concerted efforts, the surgery was successfully completed and the mediastinal tumor was completely removed!

Wait for Zhao Yuan and Zhou Guangchen to come out of the shower in the operating room.

News from the intensive care unit!

The long-term compression of the heart and vena cava relieves the pressure.

The old lady's bruised lips were also bloody......