When Dai Xuan arrived at the hospital, it was crowded here.
"Director Dai, the situation here is a bit tricky-" A doctor saw Dai Xuan arrive and immediately came over and asked her to see the CT film that she had been studying for a long time.
Dai Xuan looked carefully and found that CT showed that the patient's tumor not only wrapped the colon, but also invaded the abdominal aortic vein, as well as one side of the kidney and the spleen.
The two young doctors next to him saw Dai Xuan's eyes worried, so they asked tentatively, "Director Dai, is the tumor sticking to the abdominal aortic vein?"
Dai Xuan shook her head and said, "It's not certain yet, it depends on the actual situation."
The patient is older and is a retired leader in the city.
In the past two days, he felt difficult to defecate and abdominal distension and pain, so he came to the hospital for examination and diagnosed with intestinal obstruction.
There are usually two causes of intestinal obstruction. One is that the intestines are stacked together, like a knotted hose, and food cannot pass through the intestines. The other is that the tumor invades the intestine cavity or traps the intestines.
After abdomen CT examination, it can basically be determined that the patient's condition belongs to the latter condition. Intestinal obstruction must be immediately surgically relieved, otherwise the patient will die of shock due to absorbing a large amount of toxins from the intestines.
"There is another situation where the patient's coagulation function is abnormal." The doctor in charge of the patient said to Dai Xuan.
Due to abnormal coagulation function, surgical incisions are prone to bleeding, so everyone is a little worried.
"There is no time to hesitate. If the surgery cannot be done immediately, the patient will not last long." Dai Xuan showed her decisiveness as a leader at this time and immediately ordered the surgery to be prepared.
The patient fell asleep after anesthesia and everyone began to have a careful operation.
Blood kept seeping out of the incision. Dai Xuan used an electric knife to stop the bleeding. Usually, she used an electric knife to gently coagulate, and the bleeding stopped. Now she had to repeatedly electrocoagulate to take effect. The white smoke and burning smell of the electrocoagulation incision immediately spread throughout the operation room.
Dai Xuan, who was the chief surgeon, cut the patient's skin, fat, myofascial, and muscle layer by layer. When it reaches the peritoneum, the expanded intestines support the peritoneum, as if it is about to break out of the membrane.
When cutting the peritoneum, you must be both careful and quick. Otherwise, if you move faster, it will easily hurt the intestines, and if you move slowly, the peritoneum will easily be cracked by the intestines.
After the peritoneum was cut open, a huge tumor appeared immediately.
The surface of the tumor is smooth, as if it is a giant lock that clasps the intestinal duct.
Dai Xuan frowned and gently touched the bottom of the tumor with her hand to test the location of the tumor to determine whether the tumor was adhered to the abdominal aorta, veins, spleen and kidney.
Fortunately, the tumor was not connected to the abdominal aortic vein, but it was adhered to the left kidney.
Dai Xuan tried to mention the tumor and further determine whether the tumor could move.
At this moment, the nurse heard a loud voice saying, "Director Dai, your heart rate has dropped to forty-seven!"
Dai Xuan quickly let go, turned her head and looked at the electrocardiogram on the monitor, showing that her heart rate had dropped to forty-two times per minute.
She waved her head and the anesthesiologist quickly injected atropine into the patient, and her heart rate gradually rose to eighty times per minute.
At present, Dai Xuan can be sure that the organs and tissues that the tumor invade are not only those seen through CT and the naked eye, but also some tissues that are invisible and intangible. The operation is extremely difficult. It is necessary to cut off the tumor and intestines, and remove the kidneys. Even if the surgery is successful, if the intestines are soaked in cancer cells and cannot keep up with the nutrition, all previous efforts may be wasted.
This surgery is very troublesome, especially in small places like Huzhou.
However, the patient's condition was sudden and he was relatively old, so he could not withstand the bumps of the journey. If he was transferred to the hospital at this time, it would be more dangerous. I am afraid that he would not be able to transfer to a large hospital at all. This is why the patient's family knew it was very dangerous, but he still decided on the reason for the operation in Huzhou.
Dai Xuan thought for a while and said to everyone, "The first is to remove the tumor and the invaded intestine, the left nephrotic resection, and the surrounding lymph nodes. The second is that the tumor and the left kidney are no longer removed. Only the small intestine in the upper abdomen is bypassed by the intestine wrapped by the tumor, directly anastomosis with the colon below, and penetrate the intestine. The former is more complex and has a high risk, while the latter is simple and has a low risk. Just do radical surgery and ask the ward to prepare another 500 units of red blood cells."
After five hours, the patient's left kidney was finally separated.
Dai Xuan breathed a sigh of relief. The sweat on her forehead had soaked her hat. The nurse kept helping her to prevent the sweat from dripping into the patient's abdominal cavity. She took a breath, then picked up the blood vessel forceps and clamped the arteriovenous artery and veins of the kidneys.
Suddenly, a small mouth broke in the kidney artery, and the bright red artery blood gushed out, rotating around the kidney into a small blood vortex. Dai Xuan was shocked and quickly clamped the proximal end of the blood vessel with the second forceps, but the blood had already flooded the blood vessel and was crooked.
The assistant next to him immediately inserted the suction tube into the blood hole. As soon as the blood was sucked away, it poured out from the crack. He inserted the blood vessel clamp and the suction tube into the same time. At the moment the blood was sucked away, he took the opportunity to pinch the blood vessel to death, and the blood hole disappeared immediately.
"The patient's blood pressure fell to eighty or forty. If the surgery stopped and two units of red blood cells were injected before continuing?" the anesthesiologist made a suggestion in time.
Dai Xuan thought for a moment and nodded in agreement.
The patient is old and the blood vessels eroded by cancer cells are too brittle. If the blood vessels are ligated, it will endanger life safety.
After the blood transfusion, the patient's vital signs stabilized, and Dai Xuan began to ligate the renal blood vessels.
After five or six hours of operation, Dai Xuan's hand was a little shaking, and she repeatedly told herself to slow down. She gently pulled the black line that bound the blood vessels, and felt that the blood vessels were elastic enough, so she gradually exerted force until the blood vessels could no longer be strangled and the blood vessels did not break. She let out a long breath, then quickly cut off the intestines and kidneys that were invaded by the tumor, and then treated the various intestinal tubes.
The operation ended at 4 a.m. the next day. When the patient was sent out of the operating room, the patient's family rushed over and asked her nervously how she was in a state of condition.
Dai Xuan said to them, "The operation went smoothly, the anesthetic effect had not passed, and the patient was not fully awake. There is still a big hurdle after the operation, which is that the patient's coagulation function is abnormal. Hemostatic drugs should be used to prevent blood seepage from the wound. If you spend tonight, the condition will generally stabilize."
"Thank you so much to Director Dai-" The patient's son had just rushed back from another place and said to Dai Xuan with a look of gratitude.
Dai Xuan went out to take a shower and change clothes. When she returned to her office, she saw an envelope on the table, which seemed to be about 1,000 yuan. She knew in her heart that it was sent by the patient's family.
According to the hospital's market, doctors and nurses participating in the operation all have a red envelope, and the difference is only a few.
Chapter completed!