Chapter 1468

"We should watch more films and have more clinical experience." Zheng Ren had to leave an illogical statement.

Zhou Chunyong burst into tears.

I have been engaged in clinical for decades, but I am not experienced enough?

He sighed and saw Zheng Ren go to change his clothes, so he followed him.

"Boss Zheng, how many courses should we do before starting surgery?" Zhou Chunyong no longer mentioned the branch of the phrenic artery, but smiled and asked about the surgery.

"How many courses?" Zheng Ren was a little surprised.

"Yes, you have surgery on this side. Isn't it divided into several courses?" Zhou Chunyong thought he must have misunderstood boss Zheng.

Generally speaking, interventional embolization of liver cancer does not end in one operation.

At least, three courses of treatment should be done every 28 days to determine whether the tumor is completely embolized.

Because of the existence of tumor supporting trunk, some abnormal hyperplasia and very thin arteries and vessels can not ensure the filling state.

After the main artery was embolized, the collateral vessels began to take on the "important task" of supporting the tumor tissue.

Like a river, if the trunk is blocked, the river will flood. Once dry or insignificant tributaries have become new rivers.

The three times of interventional embolization mentioned by Zhou Chunyong is an ideal situation.

Generally speaking, interventional embolization is the most common operation to be performed about 5 times in a row.

That's why Zhou Chunyong asked.

Zheng Ren thought about it, put himself in the position of Tao Zhou Chunyong, and immediately understood what he meant.

"Director Zhou, that's not the case." Zheng Ren smiled and said, "about a week after operation, you can have surgery."

"So fast?" Zhou Chunyong found himself wrong from the beginning.

"Er... What do you say?" Zheng Ren hesitated and said, "have you ever done radiofrequency ablation?"

Zhou Chunyong was stunned by this question.

"Liver?"

"Yes."

"Yes, about 2000 cases a year." Zhou Chunyong immediately said his proud data.

"Like radiofrequency ablation, surgery can be performed as long as the embolic base is removed." Zheng Rendao: "for those less than 5cm, I think radiofrequency ablation can be solved. For those more than 5cm, radiofrequency ablation can not be solved at one time. The effect of surgery is better."

Zhou Chunyong immediately understood what boss Zheng meant.

The operation was done to support the base, and the supporting blood vessels with large tumors have been blocked. After the edema period, you can have surgery.

But

Seeing Zhou Chunyong with a hesitant look, Zheng Ren asked, "director Zhou, what questions do you have? I don't see outside, just ask directly."

"Radiofrequency ablation can be done right away. Why don't you do surgery right away?" Zhou Chunyong asked.

There are two methods of vascular interventional embolization combined with radiofrequency ablation.

Both methods were embolized and labeled, and the lesion was displayed under CT with Lipiodol, and then radiofrequency ablation was performed with CT positioning.

However, sometimes direct ablation is performed after embolization, and sometimes ablation is performed 1 week after embolization.

The difference between... Zhou Chunyong didn't find anything very different.

"Oh, that's right." Zheng Ren smiled. "First of all, I said that because the tumor is too large, radiofrequency ablation can't be solved at one time. Second... Tips surgery and liver anatomy will greatly improve you?"

"Big!" Zhou Chunyong blurted out immediately.

At the thought of the exquisite anatomy of animal liver like handicrafts, Zhou Chunyong couldn't help but be a little excited.

"That's it." Zheng Ren smiled and said, "organ intervention is basically done by radiologists now."

"..." Zhou Chunyong hesitated. He didn't understand what Zheng Ren said.

Zheng Renjian Zhou Chunyong looked confused and knew he was pulling a little far.

He changed his clothes and went out with Zhou Chunyong. While walking, he explained to him: "director Zhou, organ intervention is not very smooth."

Zhou Chunyong nodded.

He also admitted this.

Circulatory intervention has turned cardiothoracic surgery yellow. At present, cardiothoracic surgery in major hospitals exists in name only.

Without coronary artery bypass grafting, they are almost half unemployed.

Nerve intervention, with the participation of neurophysicians, also "abolished" the aneurysm surgery with watershed significance in neurosurgery.

Interventional embolization, minimally invasive, small postoperative side effects, who still goes to do surgical craniotomy?

You know, more than ten or twenty years ago, whether a neurosurgeon could operate on an intracranial aneurysm was the most important way to judge whether a neurosurgeon was mature or not.

Now, these large moves have been blown by the rain and wind.

In another 20 years, it is estimated that we can only find the traces of these techniques from the pile of old papers and how important and brilliant they were in those years.

However, visceral intervention, especially for the treatment of liver cancer, has not made progress.

Zhou Chunyong knows this.

With the efforts of myself and other interventional doctors, some progress has been made in the past ten years.

Progress is weak and slow, but Zhou Chunyong has no good way.

Zhou Chunyong thought quickly and immediately realized the possible meaning of Zheng Ren. Like his own idea, although boss Zheng is a doctor of general foreign origin, his mind is still more involved.

Thinking of this, Zhou Chunyong smiled.

"Interventional surgery for liver cancer, unlike other departments, is not done by doctors in the Department of Gastroenterology, but by doctors in the Department of radiology. This is due to historical reasons." Zheng Rendao.

Zhou Chunyong nodded frequently.

"Radiologist, no Jianghu status." Zheng Ren smiled.

Radiologists... In the medical sector, they are at the bottom of the contempt chain and are in the same position as pathology, traditional Chinese medicine, acupuncture and physiotherapy, etc.

Why does general surgery for liver cancer still exist?

General education is the largest department. Since the founding of the people's Republic of China, there have been a large number of capable people! Status in the medical profession is the highest level of existence.

There are academic disputes about whether liver cancer should be treated by interventional embolization or surgical resection. The voice is in the hands of general surgery.

Secondly, because liver cancer is a malignant disease, it will be cured after resection, which is a common understanding. And interventional embolization, where the tumor tissue is still there, is not reassuring.

The combination of the two has led to this strange situation.

"Since there is no Jianghu status and no voice, do relevant surgery and tell all doctors the actual effect of interventional embolization on liver cancer with anatomy." Zheng Ren smiled.

"Isn't it surgery?"

"Director Zhou, you don't really want to find a patient to do an autopsy. You can't do it."

Zheng Ren said earnestly.

Zhou Chunyong was sweating.

"Therefore, surgery is the best way to witness the effect of interventional embolization of liver cancer."

"But don't the surgeons have a problem?" Zhou Chunyong asked cautiously.

"Director Zhou, I'm a general surgery major." Zheng Ren smiled and said faintly.