"There's nothing to be hesitant about. Let's get on with the next thing." Su Yun said after looking at the film.
Zheng Ren nodded and agreed with Su Yun's statement.
In this case, if an esophageal stent is not inserted, the patient will soon suffer from multiple organ failure due to being unable to eat, and will die within 1-2 weeks.
The reason why it is uncertain is that when dying, everyone can survive for different lengths of time.
If the esophageal stent is inserted successfully, you can eat and you will not starve to death. Either fail, the heart stops beating, and he dies neatly on the operating table.
Of course, this is just the logic of diagnosis and treatment. When it comes to life and death, these are important matters that can rarely be judged calmly and logically.
The patient dies slowly without any treatment, and the family may just admit it. These are all diseases, these are all fate.
But if you risk surgery and die on the operating table due to an unexpected situation, the doctor will be held responsible. Director Miao…
This is part of the medical risk.
"Old Liu, who are you?" Zheng Ren then asked.
"Boss Zheng, the patient's son is a doctor in our hospital." Liu Zewei said: "I heard that you have met him."
"Huh?" Zheng Ren was stunned for a moment.
"Once, on a plane, I met a patient with aortic dissection. Do you still remember?" Liu Zewei asked.
"Remember." This experience was just once, and Zheng Ren would certainly not forget it. And when leaving Haicheng, on Xie Yiren's birthday, Cui Heming's people came over to help.
"The person who gave you antihypertensive medicine and a blood pressure monitor on the plane, named Xia Hua, is the patient's son."
"Oh, it's that old man." Zheng Ren didn't remember Xia Hua at all. He only remembered that when he boarded the plane that day, he met an old man with terminal lung cancer.
"The chance of lung cancer complicating esophageal cancer is not high." Su Yun said: "But now that the time has come, you can try surgery. It would be best if you have a doctor from your own family. I can make it clear."
Liu Zewei smiled and said nothing.
Zheng Ren felt that the film was nothing interesting. He caught a glimpse of Liu Zewei's smile and was startled for a moment. Then he asked, "What does Lao Gao mean? Are you asking me for surgery?"
"Yes." Liu Zewei nodded, "Lao Gao would like to ask you to use a flying knife to remove the esophageal stent."
This operation was not major, and Zheng Ren had no interest in it.
"Boss Zheng, Lao Gao wants to see if we can do double interventional treatment." Liu Zewei asked.
Dual interventional treatment refers to intraesophageal stent combined with interventional embolization surgical treatment.
While restoring esophageal patency, esophageal tumors are also controlled to a certain extent.
"It can be done." Zheng Ren had already thought of this possibility, and he said without hesitation: "But Lao Gao can do it too."
"There is a section that may involve the artery supplying blood to the spinal cord, and Lao Gao doesn't dare to touch it." Liu Zewei said: "If he did it, it would probably just be an esophageal stent."
After explaining the situation, Liu Zewei smiled and said, "Boss Zheng, I think Lao Gao wants you to come and check on his surgery."
Zheng Ren smiled lightly.
Lao Gao also wanted to come to the Imperial Capital at that time, but he still couldn't let go due to family matters. Go back? Take a look at old Director Pan by the way
Zheng Ren's thoughts moved when he thought of old Director Pan.
The surgery before me is not difficult. If you do it carefully, there should be no problems. If you are worried, you can perform interventional embolization surgery first, and then perform second-stage stent surgery after the tumor has passed the necrosis, congestion, and edema stage.
None of this is a problem to Zheng Ren.
"Well, then you tell Lao Gao." Zheng Ren said, "As long as he can discuss it with Xia Hua and can bear the risks of the operation."
"Okay." Liu Zewei said neatly, then he touched his head with one hand and held his mobile phone in the other hand, preparing to call Gao Shaojie.
"Lao Liu, I feel so tired when I see you touching your head every day." Su Yun said, "By the way, are you particularly envious of your floor?"
"Ah?" Liu Zewei didn't understand.
"There are more hairs on the floor than on the head." Su Yun chuckled.
"..." Liu Zewei smiled bitterly.
This Brother Yun has a completely different style from Boss Zheng. He has long been used to talking about his baldness when he seizes the opportunity.
They said they should write a love song soon...
Zheng Ren took a look and saw that it was Director Kong's phone number.
"director."
"I'm here, please wait a moment."
After saying that, Zheng Ren hung up the phone.
"What's going on?" Su Yun asked.
"There is a patient who asked me to take a look," Zheng Ren said.
Su Yun was curious and followed Zheng Ren, and the two of them came to Director Kong's office.
Knock on the door and go in. Director Kong is watching a movie.
"Boss Zheng, come take a look." Director Kong said.
Zheng Ren glanced at it and saw that it was an upper gastrointestinal tract radiograph. There seemed to be something wrong with it, so he immediately went over to it.
The angiographic films showed that the esophageal mucosa was not smooth, the upper segment was narrowed at the level of the T4 vertebral body, the upper segment was dilated, and a line-like filling defect was seen in the lower esophageal segment.
After swallowing the barium, the barium is divided into two parts in the middle and lower esophagus and flows into the fundus of the stomach; there is a small tubular barium shadow on the right side of the esophagus, which twists and turns from bottom to top and finally flows into the small opening and enters the esophagus.
"Huh? Double esophageal malformation?" Zheng Ren suddenly became interested.
"Yeah." Director Kong said: "The book says the chance is one in ten thousand, but I think the incidence rate is at least one in a million. I have only seen 6 cases in my life, and this is the seventh case."
"Do you want surgery?" Su Yun was gearing up.
"People who have extrathoracic surgery come to me for consultation, which means they are looking for someone who knows the truth." Director Kong said with a smile: "In case of leakage, we have to remove the stent."
"The operation is not difficult." Zheng Ren said, picking up the chest CT film placed nearby and looking at it.
Chest CT showed that a slender tubular structural shadow could be seen in the esophagus, with a degree of enhancement similar to that of the esophageal wall. The upper segment shared the same wall with the esophagus at the level of the T2 vertebral body, and the lower segment shared the same wall with the esophagus near the cardia.
A very typical image of double esophageal malformation.
"When will the surgery be performed?" Zheng Ren asked.
"It's said to be tomorrow." Director Kong smiled and said, "Boss Zheng, if you have time, could you come up and give me a slap?"
This kind of disease is best suited for Zheng Ren to see. Thoracic surgery and interventional surgery are all available. During the operation, it is judged whether there is a risk of esophageal fistula after esophageal repair and whether a stent is needed during the operation.
"What do Fang Lin do?" Su Yun said with a smile.
"Professor Li's patient, I don't know if Fang Lin can get it."
"Well, I called Professor Li and the surgery will be performed in the hybrid operating room tomorrow." Zheng Ren said, "It will probably be a little later. I'm watching Fu Guier and the others finish all the TIPS surgeries."
Zheng Ren was cautious and wanted to watch Professor Rudolf Wagner complete the operation. Director Kong would naturally not say anything.