The old lady had a huge tumor at the junction of her neck and chest.
According to the diagnosis, it is more than ten years old.
It's hard to imagine how she lived under the torture of illness.
Mediastinal tumors are common clinical chest diseases, with blurred borders and incomplete capsule, and have relatively strong ability to spread and metastasize.
Because of its special location, it is a ceiling-level difficulty outside the chest.
Most mediastinal tumors are benign, but some are malignant.
After a puncture, it was found that the tumor was malignant. It was really raining all night long when the house was leaking.
From the imaging point of view, the tumor has grown diffusely, constantly compressing the lung tissue and the superior vena cava from the heart.
The patient usually has difficulty breathing and eating.
As for the superior vena cava being compressed by the tumor, which made it difficult for blood to return to the upper body, the old lady also suffered from severe facial edema.
Blue lips and central venous pressure exceeding 30cmH2O are severe superior vena cava syndrome!
Choosing the best entry diameter for incision requires extensive experience!
In addition, how to induce anesthesia and complete intubation?
How to prevent nerve damage during complete tumor removal?
There are many difficulties like this.
Even in affiliated hospitals with many experts, it is quite a headache.
When Zhao Yuan first saw this case, he had one head and two heads.
After a lot of thinking, I finally decided on the plan!
Zhou Guangchen has great confidence in Zhao Yuan.
Although it was an operation that he had never done before, with Zhao Yuan's familiarity with the structure of the chest and his mastery of basic surgical skills, he should still be able to perform the operation well.
At the beginning of the operation, Zhao Yuan considered the patient's age and treated it with minimally invasive techniques.
select
Three small incisions are made under the xiphoid process, which will not cause great trauma.
Jealousy is stronger where there are more elites.
Many people watched the operation with a learning attitude, while others viciously hoped that Zhao Yuan would collapse and sink into the sand.
"The incision arc is very small, and there is basically no bleeding. The blood volume in the suction device definitely does not exceed 20mL, which is a bit scary."
You must know that the patient's sweat exceeds this number.
"The movements are not very fast, but there are basically no unnecessary movements."
"You don't even need a locator."
“A lot of assistive devices are useless.”
"That's too much! Are you trying to be cool on purpose?"
"I'm confident, why are you so anxious?"
Shang Yu never liked communicating with colleagues, but at this moment she couldn't control her emotions.
If your abilities are not as good as others, are you also blind?
The quality of his skills is obvious. Zhao Yuan's level is completely inferior to so many people present, so why should he open his eyes and tell lies?
Is it so difficult to admit that others are good?
"Xiao Shang, don't be angry, we are just chatting."
"Okay, let's stop talking. The merchant has a relationship with the chief surgeon."
Several doctors finished their sarcastic remarks and stopped commenting on Zhao Yuan.
Although they didn't take Shang Yu seriously, they knew that Shang Yu was Zhou Guangchen's assistant. If they offended Shang Yu, they would risk provoking Zhou Guangchen. There was no need at all.
Huge tumors were exposed in the field of vision. The tumors with a maximum diameter of 10 centimeters occupied the entire anterior and middle mediastinal area of the patient, severely invaded the superior vena cava and trachea, and closely adhered to surrounding nerves, blood vessels and other tissues.
"This... is a bit too exaggerated. The vena cava is almost compressed and closed."
Zhao Yuan took a deep breath.
Disaster
The speed is higher than expected.
The original surgical plan needed to be adjusted.
"Zhou Hospital, according to the plan, re-bypass the blood vessels returning to the superior vena cava and restore the original hemodynamic characteristics as much as possible."
"receive!"
Zhou Guangchen was also shocked when he saw the situation inside the cavity.
Even before the operation, the patient had prepared for the worst.
However, tumor surgery is really a blind box. Only when you open it can you know how to deal with it.
"It's over. The situation inside is very bad. The incision is too small!"
"Can such a large tumor be removed through three minimally invasive incisions?"
"What should we do now? How about making a new incision?"
Several colleagues who had said bad things about Zhao Yuan before secretly glanced at Shang Yu.
Although he appeared extremely worried, he could not hide his gloating mood.
Some words were not spoken, but the meaning was expressed.
——What a bullshit genius, the incision was wrong from the beginning.
Zhao Yuan has already made the worst assessment!
Although the situation inside the cavity was very bad, it was still within the scope of his judgment.
An ordinary doctor would have to make a new incision at this time, and even need extracorporeal circulation support.
But Zhao Yuan still chose minimally invasive surgery to remove the tumor.
Because he has this certainty.
Zhou Guangchen's scalp felt numb.
He knew that Zhao Yuan's level was very high, but it was obviously beyond his own assessment!
"knife!"
Zhao Yuan asked the instrument nurse for a scalpel.
directly into the cavity.
The blade passed across, cut, dotted, and sliced, like a veteran at the scene, gently biting his girlfriend's lips with his teeth, taking away the light lipstick without even touching her lip skin.
Experts just can't do it in the most critical part.
A fatal thing.
The limit of stripping is to explore wildly on the edge of touching and not touching.
No more, no less. If you cut too much, the tumor will be damaged, and if you cut too little, it will reappear.
Zhou Guangchen felt like he was back in his student days and kept asking himself what he should do.
The surgery is getting faster and faster!
Only then did the second and third assistants realize what a master is. Zhao Yuan and Zhou Yuan were like racing cars, stepping on the accelerator crazily.
Speed, precision, and anticipation!
However, they clearly felt that Zhou Yuan was chasing Zhao Yuan, and it was a bit difficult.
Zhao Yuan did not expect that his surgical rhythm would be improved by Zhou Guangchen.
Normally, he would not perform surgery so quickly, but today, with Zhou Guangchen able to catch up, his speed increased unknowingly.
Looking back at Zhou Guangchen, I found a hint of unwillingness and determination in his eyes.
Zhao Yuan quickly adjusted his rhythm.
As the surgeon's pace slowed down, so did Ichisuke's speed.
Zhou Guangchen secretly lamented that Zhao Yuan was being merciless. If he had continued with the intensity just now, for another ten minutes or so, he would have exploded, and he would have made a fool of himself.
This level of surgery is really hard to see in normal times.
Usually most surgeries are not so fast-paced.
Although the regulations of the operating room clearly stipulate that no noise is allowed in the operating room, there are still cases of chatting during the operation. Although people are wearing masks, people talking will produce droplets, which violates sterility regulations.
But when the level reaches a certain level, there is basically no verbal communication during the surgery.
Even when the surgeon gives instructions, he will be very clean and neat.
The second assistant and the third assistant are both chief physicians in the Department of Thoracic and Cardiac Surgery. One of them once taught Zhao Yuan, but now he discovered that
It was very difficult to interpret Zhao Yuan's technique.
Although their level has not reached the level of Zhou Guangchen, they are definitely outstanding young doctors. If they reach prefecture-level cities, they will definitely be the masters.
However, they were not very lucky today and met a genius.
However, they didn't feel uncomfortable at all. After all, Zhou Yuan was a little tired under Zhao Yuan's rhythm.
After 5 hours of hard work, the operation was successfully completed and the mediastinal tumor was completely removed!
Wait until Zhao Yuan and Zhou Guangchen come out of the operating room after taking a shower.
News from the intensive care unit!
The pressure on the heart and vena cava, which had been compressed for a long time, was relieved.
The old lady's purple lips also turned red...
