After eating the cake, Xiao Hiyama Kaori naturally focused her energy on the medical records Chen Yu gave her.

As a doctor who has just arrived at the hospital, even if she graduated from Tokyo University and studied in the UK, it is impossible for her to have patients assigned to her immediately. Therefore, during this period, Kaori Xiaohiyama was under the arrangement of Chen Yu

Help other professors and gain experience.

Kohiyama Kaori does not object to such an arrangement. On the contrary, by helping other professors and working as an assistant on the operating table, she can accumulate experience faster.

However, although Chen Yu had arranged many opportunities for her during this period, this was the first time that Chen Yu took her personally, which inevitably made Xiao Hiyama Kaori feel a little excited.

In order to show off in front of the senior brother she admired, Kohiyama Kaori naturally had to study the medical records that Chen Yu handed over to her very carefully.

Looking through the medical records, Kohiyama Kaori understood the patient's condition and why Chen Yu said this case was typical.

The patient was a 58-year-old man who was admitted to the hospital for examination because of chest tightness for more than three months. After CT examination, it was found that there was a huge mediastinal tumor exceeding 12cm in his chest, completely surrounding the superior vena cava and the left and right innominate veins.

She held up the CT image in the medical record and pointed it at the light source. Looking at the huge tumor and the jelly-like tissue around the tumor, Kaori Kohiyama couldn't help but sigh that she could actually see such a large mediastinal tumor.

The so-called mediastinum is a space located between the mediastinal pleura on both sides and behind the sternum. There are many organs and tissues in the mediastinum, such as thymus, heart, esophagus, trachea, etc., so various tumors and cysts can occur in the mediastinum.

, especially thymoma, is one of the most common mediastinal tumors clinically.

However, when tumors and cysts appear in the mediastinum, about one-third of patients have no symptoms. In most cases, they only discover that they have mediastinal tumors during a physical examination due to other reasons. Chest pain, chest tightness, cough and

Shortness of breath is the most common early symptom of mediastinal tumors.

Mediastinal tumors are not uncommon clinically, and surgical treatment is one of the more commonly used treatments, usually through thoracotomy and thoracoscopic surgery.

Thoracotomy is obviously a huge burden for patients, but when the tumor is too large to be removed by thoracoscopy, thoracotomy becomes the only option to save the patient's life.

Judging from the size of this patient's tumor, this thoracotomy may not require opening the entire chest to remove the tumor.

Chen Yu did not attach a treatment plan to the medical record, and Kaori Kohiyama didn't understand whether her senior brother was taking the exam or wanted to come up with a treatment plan, but she was still thinking about this operation out of a doctor's instinct.

What to do.

Judging from the location of the tumor, this patient should use a median chest incision combined with a right anterolateral chest incision to enter the chest. That is, a lateral T-shape should be drawn on the patient's chest to open the patient's right chest.

However, since the tumor has completely surrounded the superior vena cava, it is very likely that a tumor thrombus has formed. If the tumor is to be completely resected, it is very likely that this section of the superior vena cava will also need to be resected.

Vascular resection is a very common operation in surgery. After all, there are so many blood vessels in the human body. Except for the main blood vessels, other blood vessels are not irreplaceable.

But this superior vena cava happens to be one of the important blood vessels in the human body and cannot be replaced.

Of course, being irreplaceable does not mean that there is no way. Use artificial blood vessels for bypass, and then use artificial blood vessels to replace the original blood vessels after removing the tumor. This is what Kaori Kohiyama thought of after thinking about the possibility of tumor emboli.

The first idea is also the first choice for dealing with the situation at hand.

When Kaori Kohiyama was biting a cake fork, looking at the medical records and thinking about how to perform the operation, a hand reached out from behind her and snatched the medical records away.

"Huge malignant thymic tumor, type B2~C, invades the superior vena cava and left and right innominate veins. Is it 12cm in size?" Holding the medical record and pointing the CT image at the light, Daimon Mikiko looked at the patient's condition, and her hands suddenly

The itch started again: "Upper cavity

If there is a possibility of a tumor thrombus in the vein, an artificial blood vessel bypass between the left innominate vein and the right atrial appendage should be used to ensure blood flow back to the brain and upper body. After the bypass is completed, the entire tumor is freed and removed, and finally the superior vena cava is reconstructed with an artificial blood vessel. This surgery is given to

How am I?"

"Doctor?" Kohiyama Kaori turned around and saw the freelance doctor standing behind her. She quickly stood up and wanted to get her medical records back: "Give it back to me! That's senior brother's patient. You want it?"

Go tell your senior brother about the surgery!"

When Kaori Kohiyama said that this was Chen Yu's patient, Daimon Yoshiko felt bored: "Professor Chen Yu's patient? Forget it, I won't be his assistant!"

It's not that Daimon Michiko suddenly lost interest in this surgery, but she knew that Chen Yu would not give up the position of surgeon to her easily, and she didn't want to do useless work and end up doing Chen Yu's job.

But looking at Kaori Kohiyama, Daimon Mikiko suddenly had an idea in her mind, and said to Kaori Kohiyama with a bright eye: "Why don't you go tell Professor Chen Yu that I will perform this operation, and you can do it for me.

How about being an assistant? Isn't he your senior brother? If you go and tell him, he will definitely agree, right?"

"Hey! Demon, are you done?" Because the pronunciation of "Daemon" is very close to "Demon", Kaji Hideki has already changed the name of Daimon Unknown to "Demon": "Professor Chen Yu originally asked Dr. Hiyama Ko to be his assistant.

Yes, are you now willing to do whatever you can to get the surgery?"

"Humph, what do you know! This patient's tumor is so large. If you are not careful during the operation, you may damage the phrenic nerve and recurrent laryngeal nerve, aggravating the postoperative respiratory dysfunction. The surgeon must separate the tumor layer by layer.

With a comprehensive understanding and grasp of the relative positions of blood vessels, nerves and organs around the tumor, do you think anyone can do this surgery?" Daimon Yoshiko scolded Hideki Kachi, but still returned the medical records to Kohiyama Kaoru.

Weave.

After receiving the medical records returned by Daimon Michiko, Kohiyama Kaori breathed a sigh of relief. At the same time, perhaps in order not to weaken in front of Daimon Michiko, she also said: "The huge tumor is not clearly demarcated from the surrounding tissue and is not connected with the organs."

Due to extensive adhesion, the complete surgical resection rate will be very low. Even if the tumor can be completely removed, the possibility of postoperative recurrence and metastasis is very high, and the prognosis is poor. It must be combined with comprehensive tumor treatment methods of postoperative radiotherapy and chemotherapy."

However, when she finished speaking, Daimon Shiko looked at her with regret and shook her head: "Is it possible that you have forgotten the broad-spectrum anti-cancer drug developed by Professor Chen Yu? That new drug is about to be launched.
Chapter completed!