The main team of the Department of Gastrointestinal Surgery is still composed of the original digestive surgery team.

It's just that some digestive surgery programs are separated.

For example, pancreaticobiliary surgery, anorectal surgery.

In general, there are pros and cons to the continuous subdivision of departments. The advantage is that doctors and nurses can be more proficient in related medical fields, and they can truly strive for excellence.

This is also a general trend in the market.

With the growing strength of the Chinese country, the people's requirements for medical treatment are also getting higher and higher.

Now everyone runs to that hospital wherever they can see a certain disease. For example, the oncology department of Tuya Affiliated No. 2 has become stronger and bigger, which attracts not only cancer patients from the province, but also many cancer patients from other provinces.

Zhou Can and Dr. Chi pushed the patient into the operating room, while the patient's family stayed outside the operating room and waited.

It can be seen that both husband and wife are very nervous and their faces are full of anxiety.

The operating room has long been prepared, and the anesthesiologist and surgical nurse are already in place. Soon after the anesthesia was administered to the patient, the deputy chief physician also arrived in a hurry.

"Director Mu!"

Zhou Can was surprised that the person who came in turned out to be the arrogant person from the previous digestive surgery department. Deputy Director Mu, who is still a little narrow-minded.

"Hello Doctor Zhou! It was an honor to work with Dr. Chow on the surgery. ”

Director Mu actually took advantage of the expression, smiled happily and stepped forward to take the initiative to shake hands with Zhou Can.

In the past, Deputy Director Mu did not have this attitude towards Zhou Can.

It can only be said that this time, that time.

Zhou Can's huge potential, as well as his hidden position in Tuya Hospital at this moment, were enough to make Deputy Director Mu change his attitude towards Zhou Can. No one would refuse to have a good relationship with a future medical bigwig.

"Thank you Director Mu for your trust and support! I am the one who should be honored to have surgery with you. ”

Zhou Can didn't dare to take advantage of this person.

You must save enough face for each other.

Especially when dealing with such narrow-minded people, you should be extra careful. Sometimes I don't say a word, and I go to my heart.

"Lao Mu, I'm going to trouble you this time!" Dr. Chi and Director Mu obviously have a good personal relationship.

"What's the trouble, don't I ask you for help less? If you're polite to me, you'll really see something out of the box. Director Mu waved his hand and walked over to the patient to take a look.

At this point, the patient has already begun to enter the anesthetic state.

But it will take a little time.

"The anesthesia was successfully administered, the patient's physical signs were stable, and the operation was possible!" The anesthesiologist is always the most serious person in the operation, and all operations are carried out in strict accordance with safety regulations.

Even more serious than the main knife.

It is understandable, after all, the safety of the patient's life is their responsibility, and it is not okay if they are not serious.

"Dr. Zhou, please!"

Director Mu gestured to Zhou Can.

"Good!"

Zhou Can stood on the main knife position and began to perform laparotomy on the patient.

The scalpel came into his hand as if it had come to life, agile, swift, and heartfelt.

How long and deep a knife is cut, it is all wonderful.

As the abdominal cavity was opened layer by layer, Zhou Can electrocoagulated the patient to stop the bleeding. Large blood vessels are all perfectly avoided when incised.

The incision of the main treatment is at the medium level, and with the blessing of the quick knife method, it is not inferior to the incision level of the deputy chief physician. There is no need to worry about accidentally cutting large blood vessels and nerves.

"We'll help you pull the hook."

Deputy Director Mu and Physician Chi took the initiative to work as assistants to Zhou Can.

As the abdominal cavity was opened, Zhou Can first sucked up the blood and a small amount of ascites effusion, and then began to carefully explore the lesion.

Whether it is abdominal surgery or chest surgery, doctors need to have a strong sense of responsibility and rich surgical experience. Because when pulling the organs in the abdominal cavity, theoretically speaking, as long as they don't break, there is no big problem.

However, after surgery, the organs and tissues in the abdominal cavity may have serious adhesions, which will bring a series of troubles to the patient.

This is commonly referred to as postoperative sequelae.

Almost all thoracotomy and laparotomy surgeries have some degree of sequelae.

For example, after thoracotomy, patients often feel chest tightness, shortness of breath and other problems.

In the case of laparotomy, the risk of intestinal adhesion and intestinal obstruction increases significantly.

Many patients who have undergone laparotomy have been discharged from the hospital for half a year after the survey said that they had a certain degree of constipation, inexplicable abdominal distension, depression and other phenomena.

Therefore, a responsible doctor will conduct a comprehensive evaluation when performing thoracotomy and laparotomy surgery, and will only decide to perform surgery on the patient if it is determined that the benefits of the surgery are much higher than the possible postoperative impacts.

Zhou Can tried his best to keep the other parts of the patient's abdominal cavity from moving, and he did his homework when choosing the knife position before the operation.

At this moment, open the abdominal cavity and take the lesion directly.

Because the patient is still in the early stage of the disease, the disease is not obvious at this stage. Therefore, even if the location has been done before the operation, and the small nodules are felt when touched, when the abdominal cavity is opened for exploration, there is still no finding.

In this regard, Zhou Can has long been mentally prepared.

"I don't think there are any obvious tumors or nodules! When Dr. Zhou touches it, will it be because the other party is a young woman? Dr. Chi asked from the side.

Before opening the abdominal cavity, Dr. Chi was full of confidence in Zhou Can's diagnosis.

But after I really hit the abdominal cavity, I found out that it was not like that.

He was inevitably a little disappointed.

The main thing is that the family is not very easy to explain.

"Am I like the kind of person who hasn't seen a woman before?" Zhou Can pouted a little speechlessly, if he was so unproductive, he wouldn't be able to be this doctor. "I couldn't go wrong with the feeling at the time. Now, there is only one possibility that the abdominal cavity is opened and the lesion is not found. The tumour or nodule is very small and hidden in a tissue. ”

Zhou Can's surgical experience is extremely rich, and there are many tumors and nodules that have been cut.

Although the current situation was somewhat surprising, he quickly calmed down and cleared his mind.

The first round of search just now did not yield, and it was because he was very cautious and cautious when he operated, and he was worried about hurting her abdominal tissue.

"Put on thin, sterile gloves, the thinner the better."

Zhou Can said to the operating nurse.

The surgeries of digestive surgery all know Zhou Can and have seen his skills.

At the moment, the operation was frustrated, and they were not worried at all.

The patrol nurse hurriedly came over to help Zhou Can take off the glove on his right hand, and the instrument nurse changed Zhou Can into an ultra-thin sterile glove.

"Dr. Zhou, this is trying to find the lesion through the touch of the hand?"

Doctor Chi was stunned and instantly understood Zhou Can's intentions.

After changing into a new thin glove, Zhou Can began to pinch the patient's abdominal tissues directly with his hands. It mainly revolves around the jejunum.

"Tumors usually occur in the ileum, so could Dr. Zhou make a mistake?"

Deputy Director Mu asked.

Zhou Can shook his head, "The patient had a gastrointestinal angiogram before the operation, which showed that the lesion was in the jejunum area. I also had a strong tender reflex in this area when I did the tenderness test. There shouldn't be a mistake. ”

He didn't dare to speak too hard.

The eyes searched everywhere to identify the tissues that were most likely to have tumors.

As he lifted part of his jejunum, his gaze was fixed on one area. In my mind, I was quickly recalling the human anatomy I had learned in general class.

"If there is a tumor, it is most likely to appear in the lymph. The lymphoid tissue in the lower layer of the intestinal wall is usually rich, is it in it? ”

Faintly, he felt that he had found the lesion.

Try to gently pinch those tissues with your hands.

"It's nodular, hard, a little slippery...... No, it doesn't feel like a lymph node, but a tumor. Zhou Can's face showed an excited expression, after looking for so long, he finally touched it.

Tumors that occur in this area are the most insidious, and it is difficult to detect them with the means of examination you are looking for.

By the time it can be detected, it is often an advanced stage of cancer.

"It turns out that the tumor is hidden in the lymph in the lower layer of the intestinal wall, no wonder it can't be found!"

Lymphoma under the intestinal wall tends to develop deep along the intestinal wall, invading the serous layer, mesentery and lymph nodes outward, and infiltrating the mucosa inward, making the mucosal folds stiff.

Fortunately, Zhou Can found out in time, otherwise the girl's disease would have been treated as intestinal tuberculosis, which would have dragged on for two or three months, and she would have lost the opportunity for surgery.

[Pathological diagnosis experience value +1.] 】

[If you successfully diagnose a difficult hidden case, you will be rewarded with pathological diagnosis experience points +100.]

The reward of this 100 experience points should be given to Zhou Can.

You know, this saved a young life.

"I really didn't expect a patient to get small intestinal lymphoma at such a young age, and the mortality rate of this disease is extremely high. The difficulty lies in the fact that the disease is extremely difficult to detect in the early stages. In many patients, the early symptoms are not noticeable. ”

Deputy Director Mu's surgical ability is not good, but his theory is extremely strong.

He has published several influential papers in the field of intestinal tract.

"Dr. Zhou really lives up to his reputation, and now that he has found the tumor, his family has a very good explanation." Dr. Chi began to pat Zhou Can's ass.

Not long ago, he also questioned that Zhou Can was because he hadn't touched his sister, so there was something strange during palpation.

Only now do I understand that if you say too much, you will lose.

It's a pity that it's hard to recover from the water.

I can't take it back if I say it.

Dr. Chi couldn't help but break out in a cold sweat at the thought of treating his patient's disease as if he were intestinal tuberculosis.

It's really God.

At that time, he and Director Mo all pressed the patient's abdomen, but unfortunately they could not find that the patient had a tumor in the abdominal cavity.

Zhou Can concentrated on the operation to remove all the diseased lymph. After careful examination, it was confirmed that no spread had occurred, and he stopped the operation.

[Dissection XP +1, Incision XP +1.]

[The first time you successfully isolate a subjejunal wall lymphoma, you will be rewarded with +100 experience points for dissection.] Incision XP +100.】

One operation has earned 300 medical experience points, and they are all medical skills that are extremely difficult to improve in normal times.

Zhou Can's heart blossomed.

What made him even happier was that he saved the little girl's life. A tragic incident for a family was avoided.

"Dr. Chi, Director Mu, the patient's lesion lymph has been completely cleaned. Is the cavity sutured now? ”

"Shut down!"

Director Mu has the highest status, and he gives orders.

The patient's abdominal wound was quickly sutured, and Zhou Can sewed her as beautifully as possible. The girl has a long scar on her stomach, and it is very easy for the man to mistakenly think that he has had a fetus or had a caesarean section.

This is certainly detrimental to the patient's married life.

But this kind of thing can be explained clearly. Patients have the right to make copies of the treatment documents and examination results. This is strong evidence.

Of course, the best thing is to be in good health and not have to have any surgery.

It's just that nine times out of ten, unsatisfactory things in the world occur, and malignant tumors occur in the body, which also means that cancer secretly takes root in the body. In this case, the most important thing is to save your life.

No matter how severe the scar left on the abdomen is, it is worth it.

"I really didn't expect that the patient couldn't find out the cause of so many tests. I have been studying in the field of gastroenterology for so many years, and I have been working clinically for so many years, but I am starting to get scared. Even if I am careful and careful in my diagnosis, there is still a possibility of omissions and misdiagnoses. ”

Dr. Chi's problem happened to almost all the old doctors.

The more skilled the doctor, the more experienced he is in diagnosing and the more careful he is when diagnosing patients. Always walking on thin ice, I am afraid of a little mistake.

"Lymphoma of the small intestine is really a very difficult disease to detect. In the future, in similar cases, the endoscopy excretes upper gastrointestinal or colonic bleeding, and the patient can be tried to do a barium duplex of the small intestine. In addition, the recently popular thread swallowing test can also be used in clinical practice. If the cause of the disease cannot be found after using these methods, then do not hesitate, learn from Dr. Zhou, and decisively perform exploratory laparotomy on the patient. ”

Deputy Director Mu shared his valuable experience.

Although he was a surgeon, his diagnostic skills were not inferior to those of an internist.

Therefore, there are no absolutes.

What physicians must have strong diagnostic skills, and surgeons must have poor diagnostic skills, that is irresponsible speculation.

The thread swallow test is simple and non-invasive, and the cost is very low.

It is commonly used in some large hospitals.

On the contrary, some hospitals or departments that only think about how to generate revenue rarely use this method.

After all, before the cause of the patient's illness is found, the doctor can openly ask the patient to do all the tests. After all the inspections are done, there will be an income of two or three thousand yuan.

As for whether the patient is very uncomfortable when doing barium imaging, and it will aggravate the condition when doing some invasive tests, the doctor does not care about this.

……

The moment the patient was pushed out of the operating room, the couple who were guarding outside rushed over immediately.

"Doctor, how's my daughter's illness?"

"The operation went very smoothly and the small bowel lymphoma that was removed from the patient has been sent for pathological biopsy. A biopsy can be performed to determine whether the boundaries are clear, whether there has spread, whether it has been removed, and the nature of the tumor. The results are usually available 24 hours later, and when the results are out, I will arrange the next treatment plan based on the test results. ”

Dr. Chi said to the family.

"It's really a tumor! Thank you Dr. Chi, thank you Dr. Chow! ”

The girl's father thanked the two doctors again and again.

"This is Deputy Chief Physician Mu and the chief surgeon of the patient." Dr. Chi knew Deputy Director Mu's temperament and hurriedly introduced Deputy Director Mu's identity to his family.

"Thank you, Deputy Director Mu!"

The girl's father was somewhat sophisticated, and hurriedly thanked Deputy Director Mu.

"The surgery was mainly done by Dr. Zhou, and I was on my side to guide it. If you want to thank you, thank you Dr. Zhou. Patients who have just undergone surgery may need to fast for about six hours. Then you can eat some liquid food. Pay attention to the maintenance of abdominal wounds and do not scrub. ”

Deputy Director Mu was very busy, and left in a hurry after a few words.

The family learned that the operation was mainly done by Zhou Can, and their gratitude to Zhou Can has risen to a new level.

Back in the digestive surgery, before Zhou Can's ass was hot, Luo Jingyi, who was under Director Shang, came running.

"Doctor Zhou, if you are not busy now, Director Shang invites you to go to the Department of Vascular Medicine to participate in the consultation of a critical case."

Luo Jingyi just passed on a word.

Calculating the time, Director Shang should be sitting in the outpatient clinic now.

Zhou Can was about to drink saliva, so he hurried to the outpatient clinic to help with the auxiliary diagnosis.

"I'm just a regular trainee, Director Shang asked me to go to the vascular department for consultation, this is not appropriate!" Zhou Can has performed very well in the Department of Gastroenterology recently.

In particular, the diagnosis of various cases has won the appreciation and attention of Director Shang.

In other words, the doctors of the Department of Gastroenterology, whether they are the chief physician or the deputy chief physician, the attending physician, or the resident doctor, all highly recognize Zhou Can's diagnostic ability.

"Director Shang had already calculated that you would refuse, and he asked me to tell you that you would go to the vascular department on his behalf for this consultation. The boss also said that your level is not below him, you must be confident, and you must not weaken his reputation. ”

This trust is really heavy.

Zhou Can was lifted to an unprecedented height by Director Shang.

It was also the first time that he officially stepped out of the department and participated in the consultation of other departments in a special capacity.

Thank you book friends, Yi, tips for support.

(End of chapter)