"I have a patient here and I would like to invite you to come over to assist in the consultation."
Let her, a medical student, go over to assist in the consultation? Assisting in the consultation usually involves asking low-level doctors to consult. If they are not satisfied after the consultation, they ask the higher-level doctors to come over to assist in the consultation. Xie Wanying has every reason to think that she heard wrong.
"He is a patient who developed anastomotic leak after cardiac cancer surgery." Wei Guoyuan briefly introduced the case to her so that she could understand why she suddenly thought of asking her for help.
Cardia cancer is classified as gastric cancer in China. The incidence and mortality rates are calculated for gastric cancer. In fact, it is a junctional cancer. According to anatomical explanation, the cardia is located at the junction of the esophagus and the stomach, and it occurs here.
The tumor will naturally have the characteristics of both gastric cancer and esophageal adenocarcinoma. In the future, it will be more accurately defined medically as esophagogastric junction cancer.
Regarding the treatment of this disease, early-stage tumors are small and, like other tumors such as intestinal cancer, can be treated with a digestive endoscopy in the Department of Gastroenterology. All tumors follow the principle that early treatment has a better prognosis. It is a pity that Chinese people do not have this habit of physical examination. Early cardia cancer
The symptoms are very similar to those of ordinary gastrointestinal inflammation, and cannot be distinguished without a gastroscopy. Domestic patients are often in the middle and late stages when discovered, and can only undergo surgery.
Both general surgery and cardiothoracic surgery are departments that can perform cardiac cancer surgery. The method adopted by general surgery is to open the abdomen without incision of the diaphragm, and partially remove the stomach and esophagus. Due to the limitations of operating from the abdomen, the residual tumor at the esophageal end and
The thoracic lymph nodes may not be completely removed and may relapse easily. Therefore, more and more people choose to go to cardiothoracic surgery for this operation. The operation method of cardiothoracic surgery is to enter the chest and then into the abdominal cavity. Compared with the operation of general surgery, the patient's tumor can be removed more thoroughly.
However, there may be serious complications, such as squeezing the heart and other organs, anastomotic fistula in the chest after surgery, etc.
This patient’s surgery was performed at Xuanwu’s Cardiothoracic Surgery Department. Xuanwu’s Cardiothoracic Surgery Department seems not to be well-known, but it can definitely perform common tumor surgeries and has a certain technical level. Therefore, Xuanwu’s cardiothoracic surgery does not prevent all diseases except neurological diseases.
All common diseases can be cured, but for serious sudden injuries like Sister Xu's, the technical level is really limited and can only be treated like this.
Postoperative anastomotic leakage is a very common postoperative complication in surgery. The cause of its occurrence is related to the skill of the surgeon and has a great relationship with the individual differences of the patient. In various surgeries of the National Association of
It can be seen in all departments. How to deal with anastomotic fistula has always been a major difficulty in the surgical field. It cannot be said here that Xuanwu's cardiothoracic technique is not good. Unless there are many cases of postoperative fistula in a surgical department that exceed the normal number.
It's the proportions that are wrong.
Wei Guoyuan's classmate Dr. Shao Jialiang worked in the cardiothoracic department of the same hospital. When he encountered such a case, he wanted to ask Guozhi's cardiothoracic department for consultation. When Wei Guoyuan heard about it, he said it would be better to ask Xie Wanying to come over and have a look.
There are generally two ways to solve postoperative fistulas, either conservative treatment or surgical treatment. For surgical treatment, surgery can be performed and the laparotomy can be reopened. Endoscopic minimally invasive surgery can also be used to block the fistula. This
Usually you see a gastroenterologist.
Dr. Shao asked colleagues from the internal medicine department of our hospital for help. Xuanwu's gastroenterology department, like Xuanwu's general surgery, is relatively well-known and has such technical strength, and he came to the conclusion that it could not be done.
Why? The patient was complicated by anastomotic stenosis and the gastroscope could not enter.
