This long list of words Cheng Lei said very hard, and Zhong Yu was both happy and sad in his ears.

Her joy comes from the opportunity to explore new diseases, and her sadness is the physical and psychological torture that Cheng Lei has suffered.

Zhong Yu said solemnly: "Although I am young, I have handled a lot of cases, I have served in Nanshan Hospital and the General Hospital of the Military Region, and I have also helped many patients to regain their lives, so I will do my best to help you, you can try to believe me."

Cheng Lei was a little surprised when he heard what she said, he was in a state of high tension and trance when he came, and he didn't finish reading Zhong Yu's resume.

He hesitated, "Dean Zhong...... I was not accompanied by any family member during the treatment...... I signed all the words myself...... No problem, right? ”

Zhong Yu looked embarrassed, after all, the probability of encountering emergencies during the treatment process is still quite high.

"If you can, you might as well find a friend to accompany you, and in case something happens, I can also ask for the other party's opinion."

Cheng Lei lowered his head and pondered for a moment, he searched in his mind for someone who could come over.

"Not really...... Just let my colleague come over......"

Zhong Yu did not object, as long as someone accompanied him, asking too much would also increase Cheng Lei's burden.

After arranging for Cheng Lei to go through the hospitalization procedures, Zhong Yu called Guo Pengfei and Cai Yizhong over and discussed the surgical plan with them.

Zhong Yu was exposed to such a disease for the first time, and the two of them were the same, Guo Pengfei's brows were furrowed when he looked at the medical records, and he said in a heavy tone:

"In this case, the patient has to perform total tongue resection of the lower lip and mandible under general anesthesia with tracheostomy intubation, floor of the mouth and partial base of the tongue.

Cai Yizhong took the medical record book from his hand and said very calmly: "Since the dean has taken over, there must be a suitable surgical plan, don't worry about it."

He said this with the intention of highlighting Zhong Yu's ability, but when he heard it, he was suspected of touting and stepping on, Zhong Yu said unhappily:

"I called you here to hear your opinions, not to ask you two to raise the bar, if you can't say constructive advice, then don't talk."

Cai Yizhong's expression stiffened, and he adjusted his state and said:

"Dean, is this operation divided into two groups, one group for excision and one for flap preparation?"

Zhong Yu nodded and said, "That's what I imagined, otherwise it would be too late, and you two will have a heavy task this time."

Guo Pengfei said: "According to the size of the tongue and floor of the mouth defect, a variety of flaps or musculocutaneous flaps can be used to repair, such as platysma muscle flap, sternocleidomastoid muscle flap, trapezius muscle flap, pectoralis major muscle flap and forearm free flap, etc., but these repair methods have their own advantages and disadvantages, which flap do we choose?"

Zhong Yu said without hesitation: "The pectoralis major muscle flap has a large amount of tissue, which is especially suitable for the filling and repair of large muscle defects in the whole tongue and floor area caused by radical resection of bilateral tongue cancer.

The inversion of the pectoralis major muscle pedicle can cover the exposed large blood vessels of the neck after neck dissection, play a protective role, reduce the neck depression deformity after neck dissection, and restore the plump appearance of the neck. ”

Guo Pengfei also felt that it made sense when he heard it, and Cai Yizhong was not to be outdone:

"Dean, if the operation is divided into two groups, I'll prepare the musculocutaneous flap, I think I'm still quite skilled in this area."

Zhong Yu said with a serious face: "The survival of the pectoralis major muscle flap is very important, and in order to reduce postoperative complications, we should pay special attention to several points when designing, cutting and transferring the flap."

Cai Yizhong hurriedly took out a notebook to make a record, Guo Pengfei did the same, Zhong Yu continued:

"The length of the muscle pedicle should be sufficient, and the vascular pedicle should not be stretched after the musculocutaneous flap is sutured in situ.

Reconstruction of the whole tongue and floor of the mouth requires a long pedicle of the pectoralis major muscle flap, and the length of the muscle pedicle to be cut is determined by the distance from the base of the tongue to the inferior border of the clavicle.

In order to ensure a long enough length of the muscle pedicle, we designed the lower edge of the flap to exceed the lower edge of the pectoralis major muscle by 3~6cm, reaching the anterior rectus abdominis sheath, and lifted the anterior vaginalis of the rectus abdominis muscle together to ensure that the flap has enough blood circulation, and just used the thinner part of the flap beyond the lower edge of the pectoralis major muscle to make the free end of the tongue and the floor of the mouth, which is more natural and realistic. ”

Cai Yizhong listened very carefully, which was more complicated than the other cases he had handled, and Zhong Yu said:

"If the pectoralis major muscle flap is passed under the clavicle, the subclavian tunnel must be prepared loose enough to cut and peel off the periosteum on the medial clavicle to reduce tension.

However, care should be taken to protect the subclavian arteries and veins, and to avoid perforation of the pleura, and the tunnel should accommodate 3 or 4 fingers after adequate release of the detension.

The pectoralis major muscle flap should not be pulled vigorously when passing through the tunnel to prevent shear force between the skin and the muscle from injuring the skin perforator blood vessels. ”

Cai Yizhong listened carefully, and Guo Pengfei was also engrossed.

"The last point is that after the musculocutaneous flap is introduced into the mouth, fix the edge of the muscle pedicle and the neck muscle with a few stitches to prevent the vascular pedicle from twisting and stretching under the action of gravity.

Despite this, every time Zhong Yu says, the pressure on Cai Yizhong is greater, the greater the pressure, the more skills he can master from it, the coexistence of opportunities and risks is the norm, and Guo Pengfei can also understand the truth.

Zhong Yu saw Cai Yizhong's solemn face and said calmly:

"Can you do any of the above? If you can't do it, you still leave it to me, it doesn't matter if the operation takes a long time, and the patient can't take the risk. ”

Cai Yizhong immediately said: "I can do it, let me complete this step."

Zhong Yu was satisfied with his answer, she didn't mind taking them more, but she couldn't always stand in front of them.

"Okay, you go and think about it first, the patient's physical condition is not very good, and the operation must be carried out as soon as possible."

Coming out of Zhong Yu's office, Guo Pengfei walked in front, followed by Cai Yizhong, and Cai Yizhong shouted a little farther away from the office:

"Guo Pengfei, I think we have to talk about it."

Guo Pengfei turned his head and mocked: "What do we have to talk about, haven't you been targeting me."

Cai Yizhong didn't want the two to get too stiff, he apologized: "It was indeed my fault that day and I didn't control my emotions, I hope we don't bring these to the table, the dean will be unhappy when he sees it."

Guo Pengfei sneered: "Do you still care if Dean Gao is happy?" That's a little ridiculous. ”

Cai Yizhong shrugged, and he chuckled:

"There is no need for the two of us to make a fuss like this, in case the snipe and the clam compete for the benefit of the fisherman, it will be more than worth the loss, before I thought it was bad, if you want, we can have a meal together, this is different from Nanshan Hospital, I am also just adapting."

For a person like Cai Yizhong, it is extremely rare for him to show weakness, Guo Pengfei has no intention of continuing to compete with him, the two are not all the way after all, but they will not make a fuss, since the other party takes the initiative to make peace, he will be more generous.

"Eat is free, you just don't have to find fault with me in the future, I still have work in my hands and I'll leave first."

Cai Yizhong looked at the back of him leaving and didn't get angry, he was disappointed and dissatisfied with Xiangxiang and had a strong competitive spirit, and various reasons would inevitably lead to an unbalanced mentality.

Now that he has adapted to the new environment and understands what is most important at the moment, it is more beneficial for him and Guo Pengfei to maintain friendship.

Zhong Yu put all her mind into her work again, she repeatedly considered the surgical plan, and called to ask for the opinions of her oncology classmates, and did not forget to discuss with Ji Xueli when she went home, and finally decided on the surgical plan.

When she went to the ward with the informed consent form for surgery, she saw Yu Yue, a famous program host of the city's TV station, sitting in front of Cheng Lei's bed.

Dean Zhong ...... Yu Yue is my colleague...... I can ask her to sign the relevant procedures during my surgery......"

Zhong Yu was not curious about their relationship, she handed over the informed consent form for the operation, and said politely:

"Miss Yu can take a look at this before signing."

Yu Yue was dressed very low-key, and after she saw the content of the consent form, she asked with some concern:

"Dean Zhong, our Director Cheng's condition is very serious, is there a great risk of surgery?"

Without waiting for Zhong Yu to speak, Cheng Lei spoke: "Yu Yue...... You just sign it...... I know ......"

The two of them are colleagues from superiors and subordinates, and some words are not Yu Yue's turn, she sighed and still didn't talk much, and waited for her to sign Zhong Yu Zhengse:

"Don't eat before the operation, go to the operating room later, and the nurse will come and prepare the skin immediately."

Cheng Lei nodded calmly, and after Zhong Yu left, Yu Yue persuaded:

"Director, this is not a minor illness, the risk of choosing to treat here is too great, this Guangfu Hospital is a small hospital with no name, it has been established for less than a year, the president is so young, what if something really happens?"

Cheng Lei smiled miserably, and his tongue stiffened and said:

"I'm going to the big hospital...... Can it cure the disease? For me...... It's the same everywhere you go. ”

Yu Yue couldn't bear to turn her head, she never thought that the talented deputy director of their TV station, Cheng, would get such an illness, and it was useless to talk about it so much, so she could only take care of him as much as possible.

Because of their work relationship, they have a lot of contact, and they rarely contact each other in private except for work contacts, and it is difficult for Yu Yue to refuse his sudden request for help, and he can only hope that his operation will be successful.

After everything was ready in the operating room, Guo Pengfei and the nurse came to pick up Cheng Lei, and when it came to such a critical moment, Cheng Lei was extremely calm.

Zhong Yu saw that he didn't say much, he already had a stiff tongue and it was difficult to pronounce, so why bother him.

In this case, he had to pre-perform a tracheotomy, intubate general anesthesia through the tracheostomy, and there was no need to change the patient's position during the operation, and the "double group surgery" was implemented.

Zhong Yu's group performed total tongue resection, floor of the mouth and partial base of the tongue with the median sawing approach of the lower lip and mandible, and performed radical cervical lymphatic dissection on the side of the pectoralis major muscle flap and functional cervical lymphatic dissection on the other side according to the treatment principle of head and neck malignant tumors.

Zhong Yu didn't know if the juice of the revival vine had this effect, but it was better than nothing, and if it really didn't work, she would be ashamed.

The other group was operated by Cai Yizhong to complete the preparation of the pectoral major insular muscle flap.

After the preparation of the musculocutaneous flap is completed, Zhong Yu passes it through the subclavian tunnel or flips over the upper clavicle into the oral cavity according to the volume of the musculocutaneous flap, sutures the musculocutaneous flap, reverts the median sawn of the mandible, and uses a micro titanium plate to firmly fix it.

The donor area of the chest is sneak peeled off to make an additional incision and then pulled and sutured. Negative pressure tubes were placed in the neck and chest wounds to prevent blood and fluid accumulation in the surgical area.

The whole operation took more than eight hours, and Zhong Yu's status was online without the slightest delay, and Cai Yizhong couldn't tell that this was her first time doing this type of surgery.

When the drainage tube was placed and the operation was successful, Zhong Yu still did not relax, she said to Guo Pengfei:

"You work hard, closely monitor the patient's vital signs after surgery, strengthen tracheostomy care, and closely observe the color and texture changes of the metastatic muscle flap, so as to detect possible vascular crises early, and you don't care about other things in the past two days."

Guo Pengfei said with a straight face: "Don't worry, dean, I will not leave an inch until he passes the dangerous period."

Zhong Yu nodded, and then let someone push him to the intensive care room, as soon as the door of the operating room opened, Yu Yue stepped forward and asked anxiously:

"Dean Zhong, how is Director Cheng?"

Zhong Yu took off his mask and comforted: "The operation was successful, and after 48 hours of observation, I can transfer to the general ward if I am sure that there are no other postoperative complications."

Yu Yue's hanging heart was slightly relieved, and she said gratefully: "Thank you, Dean Zhong!"

Zhong Yu waved her hand carelessly, and then left, Chu Jianwen followed her, and she muttered softly when she walked away:

"The real person in charge of the local TV station, Hua Dan, is quite unbearable, and the facial features are not as delicate as yours."

Zhong Yu was used to her occasional out-of-tune, and said good-naturedly:

"Yu Yue's face is three-dimensional and good-looking in front of the camera, not everyone is suitable for facing the camera, I have watched the show hosted by her, and her line skills and improvisation ability are very strong, and she is quite powerful."

The most important thing in a place like a TV station is a beautiful face, and Yu Yue naturally has real skills to emerge.

Chu Jianwen also agreed with this, and she suddenly thought:

"You said that we cured Deputy Director Cheng this time, will he give our hospital publicity for free?"

Zhong Yu put away the surgical gown he had changed into, and said indifferently:

"We are a hospital and not a vegetable market, and the publicity is annoying, so it is better to focus more on the patients if you have that thought."

Chu Jianwen said with a smile: "You can't say that, the smell of wine is also afraid of deep alleys, and the publicity effect of the TV station is not ordinary."

Zhong Yu still didn't catch a cold, "There are too many patients and I can't be busy, and I don't want too many people to pay attention to our hospital. ”

Chu Jianwen leaned against the wall and said with emotion: "Your calm temperament doesn't match your age, it's good to pay less attention and have less trouble, by the way, I also received an invitation to the Ye family's birthday banquet, why don't we go shopping together at night?"

Zhong Yu was not worried about Cheng Lei, she frowned and said: "Let's go again at noon tomorrow, if there is an emergency at night, Guo Pengfei can't deal with it alone."

Chu Jianwen shrugged, "That's okay, I'll get busy first." ”