"I have a patient here and I want to invite you to help with the consultation."
Let her, a medical student, go to help with consultation? Assisting consultation is usually to ask a low-level doctor to consult and ask the superior doctor to come and assist with consultation. Xie Wanying has every reason to think she heard it wrong.
"I am a patient who had anastomotic fistula after cardia cancer." Wei Guoyuan briefly introduced the case to her so that she could understand why she suddenly remembered to ask her for help.
Cardia cancer is preferred to be classified as gastric cancer in China. Calculation of incidence and mortality is all about gastric cancer. In fact, it is a kind of junction cancer. According to an anatomical explanation, cardia is located at the junction of the esophageal veins and the stomach. Tumors here will naturally have the characteristics of gastric cancer and esophageal adenocarcinoma. In the future, medicine will more accurately define it as esophageal gastric junction cancer.
Regarding the treatment of this disease, early tumors are small, and like other tumors such as intestinal cancer, it can be solved by using a digestive lens in the digestive department. The tumors follow the principle of early treatment and good prognosis. Unfortunately, Chinese people do not have the habit of physical examination. The symptoms of early cardia cancer are similar to the symptoms of ordinary gastrointestinal inflammation, and they cannot be distinguished without gastroscopy. When domestic patients discover it, they often have middle and late stages and can only undergo surgical operations.
General surgery and cardiothoracic surgery are departments that can carry out cardia cancer surgery. The general surgery method adopts the method of opening the abdomen without incision of the diaphragm and partially excision of the stomach and esophageal duct. Due to the limitation of surgery from the abdomen, the residual tumors at the end of the esophagus and the thoracic lymph nodes may be removed and easily recurred. Therefore, more people choose to go to cardiothoracic surgery for this operation. The operation method of cardiothoracic surgery is to enter the abdominal cavity from the thoracic cavity and then enter the abdominal cavity. Compared with general surgery, surgery can completely remove the patient's tumor. However, there may be more serious complications, such as squeezing to the heart and other organs, and anastomotic fistula in the chest occurs after the operation.
The patient's surgery was performed in Xuanwu's cardiothoracic surgery. Xuanwu's cardiothoracic surgery seems to be not very famous, but common tumor surgery can definitely be performed, and has a certain technical level. Therefore, Xuanwu's extraneural disease cannot be treated, and common diseases can be treated. However, if there is a serious sudden injury like Sister Xu, his technical level is really limited, so he can only do this.
Postoperative anastomosis fistula is a very common postoperative complication for surgery. The reason for its occurrence is related to the technology of the surgeon, and it is closely related to the individual differences between the patients. It can be seen in all surgical departments of the National Association. How to deal with anastomosis fistula has always been a major difficulty in the surgical community. This cannot be said here that Xuanwu’s extra-thoracic technology is not good. Unless a surgical department has many cases of postoperative fistulas that exceed the normal proportion, it is wrong.
Wei Guoyuan's classmate Dr. Shao Jialiang worked in the same hospital outside the heart. When he encountered such a case, he wanted to ask Guozhi for an extra heart consultation. When Wei Guoyuan heard this, he said that it would be better to ask her Xie Wanying to come over and take a look.
There are generally two solutions to postoperative fistula: either conservative treatment or surgical treatment. For surgical treatment, surgery can be performed and the cavity can be reopened. Endoscopic minimally invasive surgery can also be used to block the fistula, which is usually a gastroenterologist.
Dr. Shaw has asked colleagues in the internal medicine department of our hospital for help. Xuanwu's gastroenterology department is also well-known for having this technical strength, and the conclusion is that it cannot be done.
Chapter completed!