Chapter 106: Get a hemangioma surgery?

Chapter 106: Get a hemangioma surgery?

When they were going out, Jia Yu and Yu Xiaoze also came out.

“You also go to the hospital?”

“You too?”

“You don’t go to the hospital too, right?”

At this moment, all three of them realized something was wrong.

Assessment!

The three of them immediately understood that this was the beginning of the second phase of the assessment. Just like last Saturday and Sunday, there was an assessment every day. Yesterday there was a written test, which can be counted as one, so today's test may be the correct one. play.

"Come on!"

The three of them said to each other and entered the hospital.

However, what Wu Xiaofu didn't know was that unlike him, Yu Xiaoze and Jia Yu were not going to the operating room.

Operating room.

Wu Xiaofu saw Xiaojin again, "Hey, sister Xiaojin, why do you look like you have lost so much weight? Isn't it because you have been working too hard recently?"

"It's not hard work, it's Life is hard. I have to come to work on Sundays. I am looking forward to when I can go to normal work. But, have I really lost weight?”

Although I lament that life is hard, I am still looking forward to it. Jin's eyes lit up when she heard Wu Xiaofu say she had lost weight.

This made Wu Xiaofu feel a little emotional. Sure enough, the effect of praising a girl for being thin is always more effective than directly praising her beauty. After all, thinness equals beauty. Among girls, it has long been a tacit agreement. Instead, they praise others. , these girls have long been immune to it. No matter whether you are sincere or not, you may be called frivolous.

In the operating room, Duan Hao is studying the film.

Wu Xiaofu said hello and came to Duan Hao. Looking at the film in front of him, he couldn't help but be a little surprised.

"Hepatic hemangioma?"

"Well, large hemangioma, 9cm in diameter, is rare."

Liver hemangioma is actually very common. During the physical examination at work, one of the four people might have hemangioma. However, most hemangiomas are small hemangioma and do not require special treatment. As long as you live a healthy life, you can Just re-examine.

Liver hemangioma is generally divided into small hemangioma, large hemangioma and giant hemangioma according to the diameter of the tumor. Small hemangioma has a diameter of 1-5cm, and large blood vessels have a diameter of 5-10cm. Tumors larger than 10cm are considered giant hemangioma. Giant hemangioma are still rare, even the 9cm hemangioma in front of me is rare.

Common hepatic hemangiomas are generally caused by venous vascular malformations, either single or multiple. Almost all of the hepatic hemangiomas discovered so far are benign, and malignant hepatic hemangiomas have not yet appeared.

So, currently, the only indication for surgery for liver hemangioma is that it is too large.

Hemangioma will continue to grow and grow under the constant supply of blood vessels. It depends on the speed. If the hemangioma is too large, it may affect the function of the liver.

If the hemangioma is too large, the risk of bleeding will also increase. If you wait until it ruptures before performing surgery, it will be too late.

Therefore, if the reexamination finds that the tumor has progressed to a large hemangioma, surgery will be recommended.

There are two commonly used surgical methods, one is surgical resection and the other is interventional embolization.

The latter is generally used. After all, compared with surgical resection, interventional surgery is safer and will not cause too much damage to the liver.

Of course, there are advantages and disadvantages.

Expensive!

This may be the biggest disadvantage of interventional surgery. The multiple times of the surgical fee is enough to deter most patients. More importantly, part of the price of interventional surgery is not within the scope of reimbursement. This allows more patients, even if they are willing to undergo interventional treatment, to consider the cost of surgery and their own affordability.

Of course, other shortcomings must also be considered.

Just like the liver hemangioma in front of us, the diameter is too large. One treatment may not be able to directly solve it. It needs multiple treatments. Moreover, interventional embolization embolizes the main blood vessels that provide nutrients to the hemangioma. The hemangioma will not be supplied by blood vessels and will no longer grow and may shrink.

However, it will continue to remain in the body even after surgery, hidden dangers always exist, and the treatment cycle is too long.

There is also the impact of interventional embolization agents. Many people say that interventional embolization agents can cause complications such as abdominal pain, bloating, nausea and vomiting, etc., and affect liver function and metabolism. Of course, this depends on the quality of the surgery and the amount of embolization agents. related.

Now that the patients have entered the operating room, it seems that they have chosen to undergo surgical resection.

From the perspective of general surgery, when hepatic hemangioma is larger than 5cm, direct resection is the first choice. After all, it is more convenient, simple and thorough.

After determining the condition, the pros and cons of the two surgical methods are told to the patient, and then the patient makes his or her own choice.

The patient is a woman, not very old, just in her early thirties.

Wu Xiaofu is not surprised. After all, clinically, hepatic hemangioma affects women at a higher rate than men.

Especially during pregnancy, studies have found that women who use contraceptive pills indiscriminately have a higher risk of developing the disease, which is most likely related to the secretion of estrogen and progesterone.

"Teacher, the patient does not consider interventional treatment?"

"Surgical resection is the only means of radical cure. There is a family history of hepatic hemangioma in the patient's family. The patient's mother has hepatic hemangioma. , because there was no physical examination, when it was discovered, the giant hepatic hemangioma was already ruptured and bleeding. As you know, if it is not discovered in time, the risk is very high.

The patient's mother appeared. Hemorrhagic shock requires investigation after entering the hospital to discover the specific situation. Even after treatment, the liver will inevitably fail. The patient's liver hemangioma progresses very quickly, which may be related to congenital factors. I recommend that the patient undergo interventional treatment first and observe Observation, but the patient still feels that it is better to do it once and for all.”

No wonder!

Wu Xiaofu said he understood that if a 9cm hemangioma ruptures and bleeds, the risk is not small. With such a family history, if it is not completely cured, he may never be able to rest assured.

However, removal of hemangioma requires liver incision, which will affect liver function after all. It is really a pity for such a young person.

Xiao Jin is patrolling the station and has almost prepared everything.

Duan Hao is the surgeon, with Wu Xiaofu as his assistant.

"Have you ever had liver hemangioma resection?"

"Yes." Duan Hao nodded. To be honest, he felt that Wu Xiaofu had had too many surgeries, but he could only think about it. It's because Wu Xiaofu often used his spare time to perform surgeries. Otherwise, it wouldn't be possible to explain how Wu Xiaofu could be so well-informed.

"You have also seen the film, you come and draw."

Draw the line before the operation to see how the incision is made. Duan Hao is testing him, but , Wu Xiaofu is a person who has personally undergone liver hemangioma removal, so naturally he will not have stage fright.

Take the scribing pen and start working directly.

The surgical incision for surgical resection of hepatic hemangioma is an individualized incision based on the location and size of the tumor. A long right subcostal incision or a "herringbone" incision is often used. The same is true for this surgery. However, for a hepatic hemangioma with a diameter of 9cm, the incision should be relatively large so that the tumor can be fully exposed.

Duan Hao looked at Wu Xiaofu's line drawing and didn't say much. He nodded directly. He said too much because he was afraid that Wu Xiaofu would be proud.

“Alright, let’s wash your hands and disinfect your hands.”

The people participating in the operation are all old acquaintances. The anesthetist Liu Wengui, the inspector Xiaojin and the equipment are all acquaintances. Looking at Duan Hao, everyone couldn't help but laugh.

They could see how satisfied Duan Hao was with Wu Xiaofu. After all, Duan Hao was famous for being strict. Let alone an intern, even if the attending doctor was brought here for surgery, he would inevitably be criticized a few times. How could he be like this? The first time I took Wu Xiaofu for surgery, he was so pleasant and amiable, especially Duan Hao, who seemed to like taking Wu Xiaofu for surgery more and more now.

You can tell from the fact that they see Wu Xiaofu more and more frequently.

Wu Xiaofu skillfully disinfected and spread the drapes, Duan Hao stood in the position of the surgeon, Wu Xiaofu held the gauze in his left hand, and prepared to smoke with his right hand.

The scalpel in Duan Hao's hand is just like the Qinglong Yanyue Knife in the hand of Mr. Guan. Every time the knife is drawn out, it is a beautiful curve of art. The blade radiates along the scored line through the patient's skin. Then the electric knife began to cut the ligaments. Wu Xiaofu wiped the blood and smoked to suck the blood. As an assistant, whether he let the bleeding block the surgeon's field of vision or let the smoke blind the surgeon's eyes, he was derelict in his duty.

The smell of meat penetrated his nose, making Wu Xiaofu couldn't help but sniff the tip of his nose.

The situation in the abdominal cavity was exposed. Wu Xiaofu had already prepared the retractor and retractor, and opened his field of vision in time. He should do so gently and not with brute force. The patient was under general anesthesia at this time and did not know anything. If you are too rough, , after the patient wakes up, there will be some pain and discomfort, and the skin will become loose due to too rough treatment, making it difficult to recover later.

After a few seconds, the vision of the abdominal cavity became clear under the illumination of the shadowless lamp.

Hepatic hemangioma resection is different from liver cancer resection. Liver cancer resection requires more cuts along the lesion to ensure that the lesion is completely removed without leaving any hidden dangers. However, liver hemangioma generally does not become cancerous, so it should be as small as possible. Cut, and the lymph should be preserved as much as possible.

A bulge appeared in the left lobe of the liver. It was a 9cm hemangioma, and the impact was still great.

A hemangioma that is bigger than a thumb means that the patient cannot see it. Otherwise, he may be even more scared. In fact, it is understandable. Anyone who knows that there is such a big hemangioma in his stomach will be scared. It's amazing. After all, it's not hemorrhoids. If it doesn't bleed, you can still know what's in your stomach at any time, which makes you even more scared.

Even if it is not cancerous, it does not hurt people and is harmful to people.

People with small minds may have to think about it every day, and they will not be able to eat well or sleep well. Therefore, modern medicine should also consider the psychological condition when evaluating various diseases and operations. Add it for consideration.

If you look carefully, you will find that most of the hepatic hemangiomas are buried in the liver, so if you want to completely remove them, you may need to cut more.

Duan Hao is very much like a general on the battlefield. He has killed many enemies and experienced many wars. He knows at a glance what kind of enemies are easy to kill without any hesitation. Yes, the operation has already started.

"No damage to tweezers, fine cuts."

Scan the lymph nodes first, which is an inevitable step in liver resection, whether it is a malignant tumor or a benign tumor.

It’s not that they are guilty of anything, it can only be said that they appeared in a place that the practitioner didn’t like to see at a specific time. If they affect the artist’s field of vision, if they are not cleared away, what if it happens because of them? When cutting, it will be troublesome to cut off blood vessels that should not be cut.

This work can be said to be the most time-consuming operation before the formal liver transplantation.

Based on Wu Xiaofu’s estimate, this would probably take half an hour.

Duan Hao opened his forehead gently, and Xiao Jindang, the patrolman, even started to wipe the sweat, seamlessly. However, Wu Xiaofu thought that Duan Hao had not slept well yesterday, and he seemed a little weak. This is just the beginning.

"Teacher, how about I try?"

Hmm!

Duan Hao's movements stagnated, and when he met Wu Xiaofu's eyes, he understood the meaning: This child wants to make progress.

Feeling the pain in my waist, I thought about letting Wu Xiaofu try it?

After all, Wu Xiaofu has already performed two operations in front of Duan Hao. He still has trust, and it is not small. Lymphatic removal is a delicate job, but it should not be difficult for Wu Xiaofu. I just happen to be teaching Wu Xiaofu today.

"Okay, then you try."

Wu Xiaofu was immediately happy when he heard this. God knows, he just asked tentatively, and it actually happened. It seems that the scale can be bigger in the future. Open your mouth more often, Duan Hao is too willing to give him a chance.

Taking the fine scissors and tweezers, Wu Xiaofu started to move.

In Wu Xiaofu’s hands, the scissors and tweezers seemed to have been given life and began to swim around the lymph membrane.

Wu Xiaofu's movements were very gentle, not seeking speed. It was the first time he was cleaning lymph nodes in front of Duan Hao, so it was better not to tease Duan Hao's heart.

Moreover, this is not something that can be done quickly. There are thunders under the lymphatic membrane. If you do it for a short time, you will have to make up for it later, and you will have to doubt your life.

Twenty minutes later, the lymphatic membrane that needed to be cleaned on the left side of the liver had been cleaned by Wu Xiaofu.

Everyone looked at Wu Xiaofu with strange eyes. Even though it was not the first time they saw Wu Xiaofu doing such an amazing performance, they were still shocked every time they saw it. Unlike the previous gallbladder and appendix surgeries, this lymphadenectomy, It was not an easy task. Duan Hao was sweating, but Wu Xiaofu completed it perfectly without any guidance from Duan Hao.

And even Duan Hao has to praise the work done.

The most important thing is that I don’t even sweat a drop, so I’m still young.

However, what surprised them was that when they were surprised, Wu Xiaofu actually started asking for sterile gauze.

The instrument was handed over subconsciously, and then Wu Xiaofu used sterile gauze to pad the left lobe of the patient's liver. The process was careful, just like holding a newborn child. I'm afraid that a little improper force will cause harm to it.

Of course, this is the most basic quality of the surgeon. Except for the surgical area, do not cause any additional damage to any other body parts to ensure that the patient can recover better and faster.

"High-frequency electrosurgery."

The instrument was not given in a hurry. Instead, he looked at Duan Hao. It seemed that this kid couldn't tell the difference between the big king and the big king. Let him scan the lymph nodes. Membrane, this is a rhythm that occupies the entire operation.

Please give me monthly votes and recommend votes.

There is another chapter, which is going to be posted at 8pm. I feel that if I post it early in the morning, everyone will be a little tired of following it. How about I change the update time to 8pm?

(End of this chapter)