"It would be better to watch more movies and gain more clinical experience." Zheng Ren could only leave an illogical statement.
Zhou Chunyong burst into tears.
I have been engaged in clinical practice for decades, but I am still not experienced enough
He sighed and saw Zheng Ren going to change clothes, so he followed him.
"Boss Zheng, how many courses of treatment do we need before we start surgery?" Zhou Chunyong stopped mentioning the branches of the phrenic artery and instead asked about the surgery with a smile.
"How many courses of treatment?" Zheng Ren was a little surprised.
"Yes, your surgery is divided into several courses, isn't it?" Zhou Chunyong felt that he must have some misunderstanding with Boss Zheng.
Generally speaking, interventional embolization treatment for liver cancer does not end with one operation.
At least, 3 courses of treatment are required once every 28 days to determine whether the tumor has been completely embolized.
Because there are some abnormally proliferated and very thin arteries and blood vessels that cannot maintain their full state when there is a tumor feeding trunk.
After the main trunk is embolized, the collateral vessels begin to take on the "heavy duty" of supplying tumor tissue.
Like a river, if the main trunk is blocked, the river will definitely overflow. Formerly dry or inconspicuous tributaries became new channels.
The three times of interventional embolization mentioned by Zhou Chunyong is a relatively ideal situation.
Generally speaking, it is most common to perform interventional embolization surgery about 5 times in a row.
That's why Zhou Chunyong asked this.
Zheng Ren thought for a while, put himself in Dao Zhou Chunyong's position, and immediately understood what he meant.
"Director Zhou, that's not the case." Zheng Ren smiled and said, "Surgery can be performed about one week after the operation."
"So fast?" Zhou Chunyong found that he had thought wrong from the beginning.
"Uh... how should I put it?" Zheng Ren hesitated and said, "Have you ever done radiofrequency ablation?"
This question stunned Zhou Chunyong.
"Is it from the liver?"
"Um."
"We have done it, about 2,000 cases a year." Zhou Chunyong immediately told his proud statistics.
"Same as radiofrequency ablation, as long as the embolization is supported, surgery can be performed." Zheng Rendao: "I think radiofrequency ablation can solve it if it is less than 5cm. If it is more than 5cm, radiofrequency ablation cannot solve it in one go. The effect of surgery Better."
Zhou Chunyong immediately understood what Boss Zheng meant.
It was the backbone of surgery, and the feeding blood vessels of the large tumor had been blocked. After the edema period has passed, surgery can be performed.
but…
Seeing Zhou Chunyong's hesitant look, Zheng Ren asked: "Director Zhou, do you have any questions? You can 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 for vascular interventional embolization combined with radiofrequency ablation.
In both cases, embolization and marking are performed first, and iodized oil is used to display images of the patient's diseased parts under CT, and then CT is used to position the patient for radiofrequency ablation.
But sometimes ablation is performed directly after embolization, and sometimes ablation is performed 1 week after embolization.
The difference between... Zhou Chunyong didn't notice any big difference.
"Oh, that's right." Zheng Ren smiled, "First of all, I said that because the tumor is too big, radiofrequency ablation cannot solve it in one go. Secondly... Will TIPS surgery and liver dissection improve you much?"
"Big!" Zhou Chunyong blurted out immediately.
Zhou Chunyong couldn't help but get excited when he thought of the exquisite handicraft-like anatomy of animal livers.
"That's it." Zheng Ren smiled and said, "Organ intervention is basically done by doctors in the radiology department now."
"..." Zhou Chunyong hesitated. He didn't understand the meaning of Zheng Ren's words.
Zheng Ren saw Zhou Chunyong's confused face and knew that he was going a bit far.
He changed his clothes and walked out with Zhou Chunyong. As he walked, he explained to him: "Director Zhou, the organ intervention is not going very smoothly."
Zhou Chunyong nodded.
He also admitted this.
Cardiothoracic surgery has been crowded out by circulatory intervention. Currently, the cardiothoracic surgery department in major hospitals exists in name only.
Without coronary artery bypass surgery, they are almost semi-employed.
Neurointervention, with the participation of neurologists, has also "abandoned" aneurysm surgery, which is a watershed moment in neurosurgery.
Interventional embolization is minimally invasive and has few postoperative side effects. Who wants to undergo surgical craniotomy
You must know that more than ten or twenty years ago, whether a neurosurgeon could perform intracranial aneurysm surgery was the most important way to determine whether a neurosurgeon was mature.
But now, these large-scale spells have been blown away by the rain and wind.
In another twenty years, it is estimated that only traces of the existence of these techniques and how important and glorious they were back then can be found from the pile of old papers.
However, visceral intervention, especially the treatment of liver cancer, has not made progress.
Zhou Chunyong knew this.
Driven by the efforts of myself and other interventionalists, some progress has been made over the past decade.
Progress was weak and slow, but Zhou Chunyong had no good solution.
Zhou Chunyong thought quickly and immediately realized what Zheng Ren might mean. Just like his own thoughts, although Boss Zheng is a doctor with a general education background, his mind is still relatively involved.
Thinking of this, Zhou Chunyong smiled.
"Interventional surgery for liver cancer is different from other departments. It is not performed by doctors from the gastroenterology department, but by doctors from the radiology department. This is due to historical reasons." Zheng Rendao.
Zhou Chunyong nodded frequently.
"A radiologist has no status in the world." Zheng Ren said with a smile.
Radiologists... In the medical community, they are at the bottom of the contempt chain, on the same level as pathology departments, traditional Chinese medicine departments, acupuncture and physical therapy departments, etc.
Why does general surgery for liver cancer still exist
General Surgery is the largest department, and since the founding of the People's Republic of China, talented people have emerged in large numbers! His status in the medical field is the highest level.
Regarding academic disputes, whether liver cancer should be treated with interventional embolization or surgical resection, the right to speak lies in the hands of general surgery.
Secondly, because liver cancer is a malignant disease, it will be cured after removal. This is a common perception among people. As for interventional embolization, the tumor tissue is still there, which is not reassuring.
The combination of the two has led to the current strange situation.
"Since I have no status and no right to speak, I will perform relevant surgeries and use anatomy to tell all doctors the actual effect of interventional embolization on liver cancer." Zheng Ren said with a smile.
"Don't you need surgery?"
"Director Zhou, you don't really want to directly find a patient to do human anatomy. This kind of thing can't be done."
Zheng Ren said earnestly.
Zhou Chunyong was sweating profusely.
"So, surgery is the best way to witness the effect of interventional embolization for liver cancer."
"But don't the people at the surgery have any objections?" Zhou Chunyong asked cautiously.
"Director Zhou, I major in general surgery." Zheng Ren smiled and said calmly.