Chapter 1884

Write surgical records when you see something? The mirror in your old man's hand swings like a big pendulum. What can you see!

"Have a good operation. Dr. Xia, remove pus moss and pus, about 900ml." Zheng Rendao.

"Oh, oh." Xia Hua quickly wrote it down.

"Release the adhesion below, and then it's time to open the lower pulmonary ligament." Zheng Ren continued.

Uh Did you do that?

Xia Hua tried to look at the screen and wanted to find the shadow of the lower pulmonary ligament.

The position of the current operation looks very similar, but the lens is too close, there is no overall intuitive image, and he can't determine whether the lower pulmonary ligament is being cut.

Zheng Ren released the lower pulmonary ligament and opened the mediastinal pleura.

The separating forceps are as flexible as fingers and quickly expose the esophagus to the field of vision.

"You move slowly and let Dr. Xia have a look. Otherwise, you can't write the operation record." Zheng Rendao.

"Just make it up. It's the same process anyway." Su yundao.

"Here, Dr. Xia, you see, there is a breach in the esophagus, about 2cm long. The surrounding tissue is fragile and cannot be sutured in one stage." Zheng Rendao.

Xia Hua looked carefully. When Su Yun opened the camera, he saw that there was a breach about 5cm from the esophagus to the cardia. It was white and with a small amount of pus moss.

The suture of esophagus is extremely difficult, because the elasticity of esophageal tube wall is relatively weak, the suture is forced, the tension is large, the local blood supply is not good enough, and necrosis is easy to occur after operation.

Xia Hua is still estimating what kind of drainage strip should be left in the breach in order to lead out the thick juice and exudate to avoid further infection in the chest and mediastinum.

The second stage operation is Xia Hua's first judgment.

But the timing of the second stage operation is not easy to choose, and the second stage operation of the esophagus is different from that of the gastrointestinal tract.

If you have a similar problem in the intestine, you can do a fistula. It is the abnormal bowel passage. The patient does not adapt to it and needs a period of time to get used to it.

However, if the esophagus waits for the second stage of surgery, the patient will have to feed liquid food through nasal feeding or intravenous high nutrition to maintain it.

How should nutrition be guaranteed?

"Dr. Xia, you come to help Su Yun do the rest of the work." Zheng Rendao.

Xia Hua began to worry. At this time, Zheng Ren's voice reached his ears. He was stunned and answered casually.

"Uh... And you?"

"Hey, did you listen to the disease analysis?" Su Yun was really unhappy this time. If Zheng Ren had not stepped down and touched his arm, the hemostatic forceps left when he opened the stage would have been smashed.

"Are you really going to have a second stage operation?" Su Yun said contemptuously, "under the membrane covered anti reflux stent, patients can eat 7 days after operation, and recover the stent according to the situation 14-28 days after operation."

Xia Hua listened quietly. He thought there must be something wrong. Either there is a problem with your understanding, or there is a problem with your cognition.

In short

The problem lies in yourself, not boss Zheng.

Film covered anti reflux support. What does this consumable mean? Xia Hua can understand it, but he hasn't seen it.

A bag should be brought to prevent gastric juice reflux, resulting in erosion and leakage of the wall of the covered stent.

But after the stent is removed, it can be recovered 14-28 days after operation? Can the esophagus grow.

"And after that?" Xia Hua asked.

"It depends on the situation later. If only the esophagus could grow, the operation would be successful and the patient would be discharged. If it could not grow, although it is unlikely... How about the power of your endoscope room?" Su Yun asked.

“......” Xia Hua doesn't know what the new technique is.

"They shouldn't have touched it." Zheng Ren asked Gao Shaojie to help, and then explained, "we should keep up with the nutrition after operation. The 2cm esophageal break should be easy to grow. It's really not good. The edge will not be so brittle at that time. We can solve the problem by suturing under the oesophagoscope."

Xia Hua is still confused.

"Let's talk about it then. If not, let the patient go to DIDU to find me, or I'll come back again. The probability of this situation is not high. It should grow up. Don't worry." Zheng Rendao.

"Boss Zheng, this bracket is too advanced." Gao Shaojie measured the film covered anti reflux support and said.

"Well, it's specially made to prevent gastric juice reflux. I can't use it at ordinary times. It's not surprising that I haven't seen it." Zheng Ren smiled.

Because the patient's condition was different from Xia Hua's father's condition, the guide wire went straight down.

"It's time to step on the line. Close the door." Zheng Rendao.

Gao Shaojie noticed that Feng Xuhui didn't go out, but stayed in the operating room in lead clothes.

This young man has a bright future! Gao Shaojie thought that he would stay in the operating room against the line and would not leave boss Zheng.

He regretted it for the 10000th time, but if he did it again, he couldn't leave his son who wanted to take the college entrance examination and boss Zheng to go to the imperial capital.

This is life!

Gao Shaojie was thinking about it and was ready to take off the support.

Only stepped on the line once, and the film covered anti reflux support reached the position. Boss Zheng didn't compare and directly opened the support.

"The position is just right, perfect!" Su Yun stood at the operator's position and touched the esophagus with pliers.

The covered anti reflux stent has completely blocked the damaged part of the esophagus, without any omission. It is a few centimeters up and down. The overall position selection is just like what he said - perfect!

Gao Shaojie was stunned.

The lower esophageal stent looks simple, but there is still a saying. The position up and down, the strength of stent opening and various details absolutely affect the quality of life of patients after operation.

Boss Zheng's position under the stent is just right. Judging from Gao Shaojie's rich clinical and surgical experience for many years, it is the most ideal position.

Surgery can still do this! It seems that he has no brain, but Gao Shaojie knows that this is the embodiment of countless surgical experience.

It looks relaxed. In fact, boss Zheng doesn't know how many times he has honed it.

Gao Shaojie sighed in his heart.

The preoperative diagnosis is clear, the evaluation is accurate, the operation is clean and neat, and the surgery combined with interventional surgery can transform a patient who originally needs phase II surgery into a case that can be completed with high probability in phase I.

fucking great!

Gao Shaojie sighed in his heart.

Boss Zheng beats Lao Liu with hemostatic pliers every day. Lao Liu is already strong. Gao Shaojie continues to regret.

"Lao Gao, I'll go down." Zheng Ren finished the stand and turned to step down.

"Oh." Gao Shaojie answered quickly.

The lower esophageal stent itself is not a major operation. There are not many things to do after the operation. Gao Shaojie hurried to finish.

"Dr. Xia, the operation process is probably like this. After the operation, we should strengthen nutrition and fast for 7 days." Zheng Ren told me again.

"Uh huh." Xia Hua gradually figured out the whole operation process.

Excluding the sharp, feminine assistant and gorgeous but dizzy operation, the operation is perfect!