Medical road

There are people in the dynasty who are easy to handle, and there are people in the hospital who are easy to check, let alone the head nurse in the hospital.

Nurses and sisters, large and small, are very accommodating. After a day's work, the results of the preliminary examination came out and gastric cancer was diagnosed!~

"What Zhang Yuan said is correct, what should I do now?" The head nurse of the Special Needs Department had no rules.

"Go to Zhang Yuan, wait." While talking, he thought for a while and then asked: "Do you Zhang Yuan smoke and drink?"

"I haven't smoked before, but I know he can't drink alcohol. I don't need to..."

The head nurse feels that they are all her colleagues. Although Zhang Fan is a superior, Zhang Fan is also very approachable. It is not that she is reluctant to give things away, or that she feels that she is not enough for her face.

"What do you know! It doesn't matter if you find someone to do a checkup. In this situation, you listen to me..."

People are sometimes too complicated, but it is better to be simple. Just when they are struggling, Zhang Fan has already seen the results of the inspection on the computer.

"Director Zhao, how is it? How is your health assessment of the head nurse's mother-in-law?"

"It's okay, the anesthesiology department said that it can be anesthetized. We estimate that the problem is not big here." Old Zhao replied.

"Then prepare for surgery! I will do it myself."

"Okay, Zhang Yuan."

Stomach, digestive tract, to be honest, in the digestive tract, the stomach is actually very skinny, just like a car in a certain country, if you take good care of it, you can take care of you for a lifetime.

It is not as delicate as other digestive tract organs.Let's talk about ulcers. In fact, gastric ulcers do not account for a high proportion of ulcers in the digestive tract.

Especially young people, most of them are twelve-finger ulcers. For example, some young people feel uncomfortable before they arrive, and feel sick in their stomachs. Eat two bites of rice, that’s it!

This is the typical hunger pain!The duodenal ulcer cannot escape.Moreover, this place is particularly prone to ulcers.

There is a reason for this. There is a lot of gastric acid in the stomach, but it has a bicarbonate barrier to protect the stomach wall.

But the intestine does not have this thing. It relies on bile and pancreatic juice to neutralize gastric acid. The gallbladder and pancreas open together in the intestine, and the fluid they secrete is alkaline.

However, there is a certain distance from the stomach to the opening of the pancreas. This distance is where ulcers are easy to cause, which is the famous duodenal ulcer.

If you don’t eat on time, you will be hungry and full. If you encounter a delicious meal, you can walk around the wall. If you don’t like to eat, you will lose weight.

These are the killers of duodenal ulcers.

The stomach is not so squeamish. If you eat more and less, it can usually deal with it.However, when drinking or getting angry, it becomes scared. The most scared is Helicobacter pylori.

Cancer, to put it simply, actually means that there is an inducing factor that makes the cell mass change to a qualitative change.

Any cell of the human body may become cancerous, and inflammation is the biggest inducing factor. Therefore, doctors have a saying that there are two major types of diseases, either inflammation or cancer.

Helicobacter pylori, this thing is the biggest inducing factor of gastric cancer in China.

Some patients said that I have never eaten barbecue or drink alcohol in my life, let alone get angry, but why did I get stomach cancer?

As a result, the previous medical report showed that Helicobacter pylori was positive!

Is this bacteria contagious?Infected, Chinese people have a problem. When eating, especially for children, the elderly love to feed the food they chew to the children.

The child eats any meal at any age, and eats chyle food and milk when he has no teeth.

If he has teeth, let him chew by himself. It is not necessary to let your child chew your mouth rich in Helicobacter pylori!

Also, in order to reflect their enthusiasm and politeness, I have to serve the guests.If the other party does not eat the food, you must keep your eyes on until the other party eats it.

This is how Helicobacter pylori spreads. Most gastric cancers in other countries are caused by other factors.

In China, most gastric cancers are caused by Helicobacter pylori.

The surgical requirements for gastric cancer are actually similar to those for gastric ulcers, perhaps slightly more difficult than gastric ulcers.

Many people think that gastric ulcers do not matter. To be honest, they don’t pay attention to them. Once the ulcers appear, it is super troublesome.Sometimes I don’t even have a chance to have an operation. Even if I do it, it is a super big operation.

Gastric ulcer surgery and gastric cancer surgery are generally considered high-level surgery.

For example, for intractable gastric ulcers, once surgery is required, in China, you usually choose to have your stomach cut. What does it mean is that you cut most of your stomach, and it almost directly becomes the existence of the esophagus and the intestines. .

You can think about the terrifying nature of eating white steamed buns and swallowing them directly into stool. What is even more frightening is that if you swallow half of it and then vomit, what should I do?

Looking at the whole world, countries where there are too many fish to eat smoked fish have a high rate of gastric cancer, such as the country of meatballs and Iceland.

Although Maruko Country is a rather weird country, let alone Iceland when it comes to gastric cancer, even in the world, people’s technology is the leader and familiar, but Iceland is not familiar with it.

Wanziguo has done well for gastric cancer, and endoscopy is also good.Think about it carefully, this country is very good at doing dojos in this snail-lion shell, and the small methods are very powerful.

People’s hearts are changed, and people’s feelings are changed. The head nurse looks at the two cigarettes and two bottles of wine in his hand, and complains to her husband: "Why do you think everyone is the same as you! Our Zhangyuan is different."

Zhang Fan didn't hear this, because he had already brought Ma Yichen, Zhao Quanping, and Lao Song into the operating room. If he heard this, he would probably be proud of it for a while.

The difficulty of gastric cancer surgery is not in the removal of the tumor. The stomach is not like the liver. The liver is like a honeycomb. There are various vascular pathways in it. If one is done well, it is...

The stomach is just a fleshy skin bag. The blood supply is ligated and it can be cut. The difficulty lies in the suture and lymphatic dissection after resection.

In the operating room, Ma Yichen was preparing for the operation. The young man was suffering. When Zhang Fan was fighting for the liver, he was also fighting for the liver.The technology has improved very quickly, and now it feels like a head start in general.

"Yuan Zhang, Director Zhao, brush your hands!" The anesthesiologist said to Zhang Fan.

"Okay!" Zhang Fan replied, and went to brush hands with Lao Zhao.Lao Zhao's recent life is very comfortable.

Because several deputy directors didn't rebel anymore, they were all frightened by Zhang Fan, not to mention the high level of skill, and they were so capable, they were all fainted, and probably no one else.

At the beginning of the operation, Zhang Fan was in charge of the operation, and Ma Yichen was the third helper, and Ma Yichen was the first helper, but he didn't know how he blended with Lao Song in private. Now Lao Song has become the third helper, and he has become the second helper.

Zhang Fan is hard to say about this kind of thing, he can only rely on whether he can get the hang of it.

Tumor resection surgery, what remains unchanged for thousands of years is to ligate the blood vessels first. The blood vessels of the stomach can be said to be divided into two major parts.

How do you say the shape of the stomach, it is actually crescent moon. For slender people, most of the stomach is thin crescent. For short people, the stomach is mostly fat crescent.

The inner side of the crescent is called the lesser curvature of the stomach, and the outer side of the crescent is called the greater curvature of the stomach.The blood supply of the small curve comes from the main abdominal trunk hidden under the stomach. This thing is the thickest blood vessel in the abdomen, which is the main trunk from the heart.

The blood supply for the greater curvature comes from the splenic artery on the side of the stomach.

The old lady's gastric cancer has not penetrated the stomach, but the area is too large, so Zhang Fan decided to have a total gastric surgery.

That is why Zhang Fan dared to do it. There is a saying about cancer that the old, the weak, the sick and the disabled cannot do it, and they usually choose palliative treatment.

It means that you can live for a few days as a few days!It is not that the doctor is cruel, but that the patient is afraid of death on the operating table.

Entering the abdomen and stretching, Zhang Fan began to ligate the blood vessels. With the metal click of the forceps, Zhang Fan and the others clamped each blood vessel.

The only troublesome thing is that the blood vessels of the greater curvature of the stomach are all dressed in a yellow coat, that is, all are hidden in the omentum.

What is omentum, yellow fat, it's opaque, not stockings."It should be noted here that no matter how sure you are, you must see it with your own eyes and touch it with your hands to hold it."

While Zhang Fan did it, he told Ma Yichen the key points.

"Yeah!" Ma Yichen listened very seriously.

The passer-by Doctor Lagou Lao Song was so envious that he had nothing to do, and he couldn't do much, because he couldn't see the operation field. This operation only used his hands and didn't need to think about it.

"Hey, my little horse has a good life. I met such a good teacher! If I had to have such a hand-in-hand teacher back then."

Lao Song was not very old, but very embarrassing. He was seven or eight years younger than the deputy directors. When he entered the department, it happened to be when the deputy directors were rushing to practice.

Therefore, he can be regarded as an appendix for many years.If there is no chance at the age of long technology, the final upper limit is not high.

The blood vessels were ligated, the ligaments hanging from the stomach were separated, and most of the abdominal organs were fixed by ligaments.

Without this ligament, one can't do vigorous exercises, otherwise the kidneys may fall out from the urethra first...

After separation, he clamped the esophagus and intestine connecting the stomach, "Knife!" Zhang Fan said to the instrument nurse.

The scalpel, Zhang Fan holding the scalpel, cut off the stomach from the esophagus and intestine directly along the edge of the forceps, and then Zhang Fan probed with both hands, as if holding a watermelon, took the stomach out of the abdominal cavity.

At this time, looking out of the shadowless lamp, the abdominal cavity became a large hole, and the lonely spleen on the right side and the large blood vessels below were all exposed.

Zhang Fan's general level can no longer be underestimated. If the surgical field is described by an adjective, it is clean!Yes, it is clean.

There is almost no blood stain, it is like moving a knife on a rubber doll, this is the level.

Some doctors don't pay attention to small blood vessels, but if there are too many small blood vessels, it is big blood vessels. After an operation, it is like a bottle of tomato sauce. Not to mention the patient, even he himself was stained into a red ball.

That's it, he is still triumphant!I have an operation!Those who don't know thought he killed pigs.

Old Zhao, admired Zhang Fan's level very much, and took out his free time in Zhang Fan's stomach.

He said: "Zhang Yuan's surgery is like art. The cleanliness of the surgical field is perfect."

But I didn't say much, because the difficulty of surgery is coming. Cancer surgery is difficult. What is the difficulty?Lymphatic dissection.

It can be said that lymph is like yellow sesame seeds sprinkled near blood vessels.When there is more, seven to eight or so will gather together, and when there are few, three or four.

Cancer surgery pays attention to cleanliness, because many cancer metastases are lymphatics.

If the patient wants to live a few more years, the lymph must be cleaned.These things are hidden in fat.

And not to mention hiding in fat, it also relies on blood vessels to clean up lymph, which is not only slow, but also dangerous.

This thing is either lying on the big blood vessels or hidden near them.

It is not dangerous if the needle is used for cleaning, but it is estimated that the patient will hang up after the needle is picked, because it takes too long.

Just use a curette, a magnified ear pick, and scrape along the large blood vessels.

How dangerous it is, let alone the big blood vessels like the abdominal trunk, it is fatal to puncture the smaller abdominal artery.

This kind of artery is like a snake's head. Once it is broken, its powerful muscles will shrink even if it is nourished with blood, making it extremely difficult to serve.

Zhang Fan began to dig around the abdominal cavity with a curette.

This strength should be fairly stable, and it won’t be scraped off if it is light, the scraping will not be clean, and the operation will be in vain.If it gets heavy, the blood vessels will be scratched, and the operation will be done for nothing.

Zhang Fan shaved very quickly, and the patient was too old, and she could not hold on for too long.Zhang Fan must be fast.

Wow!

Wow!

Zhang Fan scraped it off at once, just as fast as a fat man digging for ice cream.

Not to mention Ma Yichen, Lao Zhao squeezed his hands into fists.It was too frightening.The metal curette, visible to the naked eye, was doing things on the thick abdominal cavity, and Zhang Fan was quicker than he did.

The old Zhao, who was sweating coldly, couldn't help looking at Zhang Fan. Although he saw Zhang Fan's expression very concerned, he was still worried.

Because Zhang Fan's operation was too fast, he had never seen anyone with such a quick technique.

He wanted to persuade, but watching Zhang Fan's abdominal cavity dry, he didn't dare to say.

He was afraid that he would interfere with Zhang Fan.

"It's going to die, it's going to die!" Old Zhao shook his hands a little.

As the second assistant, Ma Yichen was excited.

He was shouting in his heart, "This is called technology, this is called technology, handsome!"

Newborn calves are not afraid of tigers. Although he knows the degree of danger of surgery, Zhang Fan's hand is too handsome.

"I don't know when I can learn this hand!"

Zhang Fan's hand is too steady.

After cleaning the lymph, inside the curved dish, like ice cream with strawberry juice added to the same yellow cream, there are even small particles on the surface of the strawberry. The red is blood, and the small particles are lymph. It looks like a TM.

After cleaning up, Zhang Fan checked again and started to sew again. What?

Suture the esophagus, sewing the esophagus to the small intestine.

The esophagus does not have a coat, because it is not like the intestine, it has to be squeezed together and peristaltic, so it has no serosal layer on the outer layer.

The esophagus does not move, so what can clean up the esophagus residue is saliva. Some people like to spit when nothing happens, stop vomiting, and vomit again, the esophagus will become sick.

Without this coat, stitching is very troublesome, it is directly exposed muscles.

At this time, the muscles are like wires without insulation tubes, and the wires inside are loose.

This suture, doctors with poor skills, let alone sew the esophagus to the intestines, don’t sew the esophagus.

"Line 0! Open the imported absorbable line." Zhang Fan said nonsense to the equipment.

This line is more expensive than domestic ones, and the difference is more than ten times, but this line is really easy to use.

The stitches are layer by layer, the end of the thread is flying in Zhang Fan's operation, and the stitches of the esophagus and intestine are beautiful.It's directly as if they were grown together in the first place.

After the suture, the raised duodenum must be fixed, because the stomach is missing, if the duodenum is not fixed.

Which is terrible, maybe a shout, pull it all together, the intestines are pulled off, and then a section of blood hula wiped out from the mouth.

In six hours, Zhang Fan and the others finally finished the gastric surgery.After the abdominal cavity was closed by sutures, Zhang Fan was holding a knife and was about to attack the cut stomach.

At this time, because of the lack of blood and temperature, the fat on the surface of the stomach has become stale. If it is steaming, it will be directly like a French meal of pork belly and goose liver.

After cutting the stomach, the tumor inside was exposed, just as terrible as the nest of the opposite sex in the movie, with blood vessels on the surface and rotting like yellow phlegm inside.

"Take it and let the family see the same thing, and get a medical examination!"

"it is good."