Pancreatic solid pseudoR head tumor, in fact, is a kind of pancreatic tumor with a relatively low degree of malignancy, and the main incidence group is young women, if it can be surgically removed, the prognosis is relatively good.

However, although the degree of malignancy is low, if it is not removed, it will be very troublesome, and it will endanger the adjacent organs and even life.

After all, it's a tumor.

Even if it is a benign tumor, it is too big, and it is definitely not a good thing.

Moreover, this tumor can occur in any part of the pancreas, and it is best for young women to have stomach problems, abdominal pain, etc., which cannot be identified.

No matter what the disease, early detection and early treatment are the best policies.

It will not be good to wait until a minor illness drags on to a major illness, and a mild illness drags on to a serious one.

Zhou Qiao's shot must be a high-quality product.

The girl is hospitalized in the hospital and is in very good condition and her discharge is just around the corner.

Naturally, their family is also happy, and the girl's mother plans to celebrate the Lantern Festival. The New Year is very bleak, but the Lantern Festival has a sense of ceremony.

Life needs a sense of ritual in order to move forward optimistically in the rugged and bumpy and difficult life.

The girl began to look forward to school life again, and when she recovered, she could finally return to a good school.

Learning is one thing and another......

Lying on the hospital bed, looking out the window, she couldn't help but think of the boy she had a crush on.

Because of this illness before, the mind that had been extinguished a long time ago became active again.

"Alas, I took a year off from school, one year later than him, and I don't know if there is a chance?"

It is normal for a girl to have a spring. Many single female nurses in the county people's hospital also think of spring every time they see Zhou Qiao.

Human.

Many women are actually good-looking, Zhou Qiao is so handsome and capable, how can they bear it?

No, Zhou Qiao was eating in the hospital cafeteria at noon, and two bold nurses took the initiative to come forward.

"Doctor Zhou, let me invite you to drink milk tea!" One of the girls had spring eyes and a slender figure, staring at Zhou Qiao and saying with a smile.

Her eyes were full of scorching, as if she was going to eat Zhou Qiao.

As for the other girl, although she also likes Zhou Qiao, she knows that her appearance is too poor, so she has no extravagant expectations, but comes with her best friend.

"Thanks, but I don't like milk tea." Zhou Qiao smiled slightly and declined. , he likes; Tea and like it too. But all together, well, it tastes pretty good.

Zhou Qiao's smile made the girl's heart melt, even if he said something refusal.

"Dr. Zhou, do you have a girlfriend?" The girl sat down beside him, came closer, rubbed in some places, and asked boldly.

Zhou Qiao smiled: "Yes." ”

"That'...... You can try a different one and try a new flavor! The girl recommended herself, and it was the first time she said such a bold thing, and she was really a little shy.

I couldn't help but get a little closer.

She smelled the masculinity on Zhou Qiao's body, and couldn't help but feel faintly hot.

Zhou Qiao: "......"

Are all girls so hot and active now?

"Well, I've changed a lot, I've had a lot of girlfriends." In order to let the other party retreat, Zhou Qiao told the truth very shamelessly. He does have multiple girlfriends at the same time. I don't know how cool it is in the United States.

The girl blinked, tender as water: "Does my brother mind having another one?" ”

"Poof~" Zhou Qiao was eating and almost squirted. I go, I can't bear it, I can't bear it.

Fortunately, Director Zhang of the Department of Cardiac Surgery appeared in time and walked over with a plate: "Doctor Zhou, do you have time to go to the cardiac surgery ward later?" We just admitted a patient and it feels like it's a bit uncertain. ”

"Okay, let's go together after eating." Zhou Qiao said loudly.

Because Director Zhang came to sit down, the two girls fled as if they were flying.

Director Zhang quipped: "I shouldn't disturb your peach blossom luck, right?" ”

Zhou Qiao shook his head and said, "It's just in time." ”

"Actually, girls are generally not so proactive." Director Zhang smiled, and while taking a big bite of dry rice, he whispered, "That girl just now is a famous beauty in the hospital, and many people chase her, but she doesn't care about it." She took the initiative to post it just now, and I don't know how many pairs of eyes are staring at it in this cafeteria, and many single male doctors are estimated to be heartbroken. ”

"Really?" Zhou Qiao looked left and right, indeed, many pairs of eyes met his eyes, and they all avoided it.

Director Zhang smiled: "I also listen to the gossip of the doctors in the department." ”

Zhou Qiao shrugged.

Actually, he's really not interested in girls in general now. After eating the delicacies of the mountains and seas, how can you see the general?

The nurse just now was indeed beautiful, with a face value of at least 90 points or more, but compared with the five beauties of Iris, it was far behind.

If Zhou Qiao is not a picky eater, he can burp at the county people's hospital. It's a pity that his eyes are now in the sky.

After eating, I went to the cardiac surgery ward with Director Zhang to learn about the patient's condition.

The other party suddenly fainted this morning, and then was sent to the emergency department by a colleague, and after an emergency examination, he was shocked to find that there was a tumor in the other party's heart, so he was transferred to the cardiac surgery ward.

The cardiac surgeon informed Director Zhang that for such a serious condition, it was natural to invite Dr. Zhou.

It's just that Director Zhang didn't rush to invite, but studied it himself first. The more he studied, the more suspicious he became.

It's a bit weird.

The patient, a woman in her thirties, had a 70mm*32mm mass in her right atrium, which was likely the cause of her chest tightness and syncope.

However, after being admitted to the cardiac surgery department, further examination was done, and Director Zhang came out of the provincial hospital, and his ability was still a little, and he felt that the "pedicle" of the patient's tumor did not seem to be in the heart, but in the inferior vena cava, which is close to the liver.

If you can't determine where the "root" of the tumor is, it is definitely not possible to remove the tumor directly.

It's like cutting grass and getting rid of the roots. Directly removing the tumor is equivalent to cutting off the branches and leaves on the ground, and the root system is still there, and it will still recur.

And once it relapses, it tends to get worse.

Zhou Qiao looked at the film carefully, and said: "Director Zhang's concerns are very right, let's do a cardiac MRI, scan it layer by layer, and in addition, focus on scanning the patient's uterus." ”

"Womb?" Director Zhang was suspicious.

Not only Director Zhang was suspicious, but the patient and her husband who accompanied her also widened their eyes.

What the heck? I have a tumor in my heart, why do you sweep my uterus? This doctor can't be a rogue doctor, right?

The patient's husband also thinks similarly.

It's just that they suddenly thought about it again, and said in their hearts, this doctor is so young, even the director of the department respects him so much, listen to his orders, isn't it the famous doctor Zhou who came back from the United States to visit relatives?

Isn't Dr. Chow gone yet?

Zhou Qiao is now in Zhuhai County and is already a household name. Even some people who have never been sick at all have more or less heard of such a person. It's just that many people still don't know what he looks like.

Even if it is some popular flowers in the entertainment industry, there are many people who don't know it. It's normal for people not to know Zhou Qiao.

So, further inspections were arranged.

Zhou Qiao and Director Zhang went to the imaging department in person and stared at the scan results.

Sure enough, the root system of this tumor is quite deep.

From the heart downwards, it was found that even after the diaphragm level and into the abdominal cavity, there was still a mass in the inferior vena cava at the level of the liver.

According to Zhou Qiao's suggestion, the radiologist scanned down layer by layer, and soon, the upper abdomen was scanned, but there was still a mass in the veins, so the lower abdomen was scanned again.

Sweeping all the way to the pelvis near the base of the thigh, the source of the lump was finally discovered.

It's really in the womb.

In addition to the heart, the mass in the patient's body extends from the inferior vena cava to the left internal iliac vein.

It is a "meandering", unusually long tumor, from the left internal iliac vein located in the pelvis, along the inferior vena cava, all the way up to the right atrium, like a "creeper".

At the same time, fibroids were naturally found in the uterus as the root cause of occurrence.

Zhou Qiao said: "Similar to what I expected before, this should be a case of extrauterine vascular leiomyomatosis." ”

Everyone was stunned!

Radiologist: "......"

Director Zhang: "......"

Patient and husband: "......"

Especially the patients, they are really confused.

"It's been a long time, is it caused by a gynecological disease?"

"I'll go, this Dr. Zhou will still see gynecological diseases?"

This is a rather complex, rare, and difficult case, and Zhou Qiao immediately convened the teams of cardiac surgery, gynecology, radiology, anesthesiology, and interventional radiology of the County People's Hospital for multidisciplinary consultation.

In fact, it is also through this case that I will give you a lecture.

Dr. Zhou gave a lecture, the sky was falling, the ground was full of golden lotus, and the people listening were in high spirits.

Most of the energetic doctors are young female doctors, and they don't know how active they are to "listen to the lectures".

Especially the female doctors from the gynaecologist. Before, they didn't think that they would have the opportunity to cooperate and communicate with Dr. Zhou.

Intravenous leiomyomatosis, a very specific leiomyomatosis, can pass through the uterine area, grow into the venous plexus next to the uterus, and grow up the veins in the pelvis and along the inferior vena cava all the way to the heart.

The maximum diameter of the tumor in the patient's right atrium is 70mm, and the difficulty of surgery can be imagined to remove the tumor that runs through the entire thoracic and abdominal cavity!

Therefore, this multidisciplinary consultation took a particularly long time, and the plan formulated by Zhou Qiao was extremely detailed.

"Is the surgery done to open the uterus or the heart first? Do it in two or all at once? ”

"In addition, the patient has a history of hypertension, how is the anesthesia protocol formulated?"

One question by one, Zhou Qiao explained it meticulously, and at the same time, he left time for everyone to ask questions, and he came to solve his doubts.

……

After the consultation, according to Zhou Qiao's plan, the interventional radiology department performed an imaging of the patient.

It was found that the inferior vena cava was almost completely blocked by the tumor, and blood from the lower limbs could not flow back to the heart through this main venous vein.

This is an important cause of her fainting, chest tightness and dizziness.

Fortunately, this time I fainted, I was taken to the hospital and found out.

Otherwise, the time will be prolonged, the condition will become more serious, and it will be life-threatening at any time, and sudden death will occur.

In order to minimize the trauma of the patient, the operation was performed by Zhou Qiao himself, and Director Zhang of the Department of Cardiac Surgery and Director Liu of the Department of Gynecology acted as assistants.

At the same time, there are several other senior doctors' assistants. and many assisting health care teams.

For such a major operation, the opportunity is rare, so the number of people in the operating room and monitoring room is only a lot more, just like the previous times.

The hardware conditions of Zhuhai County People's Hospital are okay, after all, they are planning to impact Sanyi, so they have purchased a lot of advanced equipment.

However, the software strength is not good.

For example, the extracorporeal bypass machine they purchased has not really been used since they bought it.

This should be considered a real first time.

Because of this surgery, the tumor in the right atrium of the heart is removed, and it is impossible to do it by minimally invasive, or if the heart does not stop. This tumor is too big and too long.

With the assistance of the two directors, Zhou Qiao first removed the uterus and ovaries of the patient to avoid the recurrence of the tumor caused by hormone secretion in the future.

The patient had already given birth to a pair of children, so when the surgical plan was communicated, the patient and her husband agreed.

It's important to save your life, where can you take care of so much.

During the operation, Zhou Qiao found that there was tumor tissue in the patient's left uterine vein, which was consistent with the previous reading results, and also confirmed that the previous judgment was correct, and the tumor grew upward from the left uterine vein.

Subsequently, under the guidance of Zhou Qiao, the cardiopulmonary bypass group of cardiac surgery established cardiopulmonary bypass for the patient.

When he opened the right atrium and saw the tumor, Director Zhang gasped.

"Doctor Zhou, it seems that this can't be completely removed?" Director Zhang raised his own questions.

If it cannot be completely removed, it will not only cause more trauma to the patient, but also may cause incomplete tumor dissection.

If the cleaning is not thorough, that is, the grass is cut without roots, and it is easy to recur.

Zhou Qiao naturally wouldn't allow this to happen.

"It's okay, I'll make a little more incision down the line." Zhou Qiao's ability to respond on the spot was undoubted, and he saw that his hands moved lightly, and soon, the distal inferior vena cava and the left common iliac vein of the patient were fully exposed.

The "pedicle" of the tumor is located in the left internal iliac vein, and Zhou Qiao incised the patient's left internal iliac vein, left common iliac vein, and distal inferior vena cava, loosened the root of the tumor, and then retracted the right atrial wall and slowly pulled out the tumor.

Half an hour later, a strip-shaped tumor of extraordinary length was finally removed completely. The patient's heart rebeat successfully.

The whole operation process actually did not last long, just over an hour.

This made all the medical staff involved in the operation admire and say that they have opened their eyes!

Because, for such a complicated operation, everyone thinks that it is very common to do it for five or six hours, or even seven or eight hours.

Who knows, Dr. Zhou is so "clean and neat", it can be done in more than an hour!

Dr. Zhou's shot is naturally a quick word.

Some things must be fast, because cardiopulmonary bypass is a big blow to the patient, and if the time is prolonged, there is a possibility that the rebound will fail.

Zhou Qiao is very measured, when can he slow down a little, give everyone more time to observe, and watch more carefully, but when he must speed up, he will not hesitate.

Due to the top-notch quality of the surgery, the recovery of the post-operative patient is also quite fantastic.

The next day, after Zhou Qiao's ward rounds, he informed the patient and his family that he should be able to be discharged from the hospital smoothly in a week at most, before the Lantern Festival.

Patients and their families were stunned. Such a major operation, can you be discharged from the hospital so quickly?

They were all mentally prepared to stay here for a month or two.

However, the recovery in the next few days proved that Zhou Qiao's prediction was quite correct.

The patient's family has nothing to report, only to customize the pennant.

Thanks to the "floating post-70s" 500 coins for the reward.

(End of chapter)