The old lady had a huge tumor at the junction of her neck and chest.
According to the diagnosis, it has a history of more than ten years.
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, and it was really raining all night.
Judging from the images, 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.
If your lips are blue and the central venous pressure exceeds 30cmH2O (water column), this is 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 resection?
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.
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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 surgery with a learning attitude, while others viciously hoped that Zhao Yuan would fail and sink into the sand.
"The arc of the incision is very small, and there is basically no bleeding. The amount of blood in the suction device definitely does not exceed 20mL, which is a bit scary."
You must know that the patient's sweat is more than 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 the assistive equipment is useless."
"That's too much! Are you trying to be cool on purpose?"
"You have confidence, 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 bother telling lies?
Is it so difficult to recognize the excellence of others?
"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. Offending Shang Yu would risk provoking Zhou Guangchen, so there was no need at all.
Huge tumors were exposed in the field of vision, with tumors up to 10 cm in diameter occupying the patient's entire anterior and middle mediastinum, severely invading the superior vena cava and trachea, and closely fitting with 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 needs 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.
Although before the operation, the patient's condition was 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? Do we need to make a new incision?"
Several colleagues who had previously said bad things about Zhao Yuan 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, he made the wrong incision 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 scratched, 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.
Fatal things.
The limit of stripping is to explore crazily on the edge of touching and not touching.
Not too much, not too little. 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, constantly asking himself what he should do if he did something.
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, prediction!
However, they clearly felt that Zhou Yuan was chasing Zhao Yuan, and it was a bit difficult.
Zhao Yuan did not expect that Zhou Guangchen would improve his surgical rhythm.
Normally, he would not perform surgeries 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 chief surgeon's pace slowed down, so did the first assistant'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 situations where people chat during the operation. Even though they are wearing masks, droplets are generated when people talk, 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 it is discovered that he is
It is 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 go to 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 pace.
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 from 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.
