The most common complication after esophageal cancer surgery is anastomotic leakage.
Because the elasticity of the esophagus is not good, blood supply problems may occur after anastomosis, leading to a series of complications.
The higher the esophageal cancer is, the more difficult it is to treat, because the higher the stomach is pulled, the greater the tension. The greater the tension, the worse the blood supply at the anastomosis.
Lin Ge knew all this, and he felt a little embarrassed when he saw Professor Lu say this, and he knew why.
There was a fistula at the anastomosis, local tissue congestion and edema, and the healing was not good. When removing the stent, if the stent pokes into the anastomotic part that has not completely healed, it may cause greater tearing.
Otherwise, Director Luo wouldn't have said that he refused to do a gastroscopy at the beginning because he was worried about its occurrence and development.
The patient's current condition has nothing to do with 912. Once there are secondary, especially traumatic operations, it will be 912's fault.
"When will Director Kong step down?" Lin Ge asked.
"It's almost done." Professor Lu said, "It's really embarrassing to ask Director Kong for help every time."
"Okay, the patient's condition is clear. Are the other positions okay?" Linge asked.
"Uh... Director Lin, it seems that the other positions are fine now. Don't scare me." Professor Lu said: "It's been one month since the operation and it hasn't grown yet. It's really possible that people will be sick if they sneeze." Case."
This is an old joke of 912.
A few years ago, a similar patient had ordinary esophageal cancer and did not undergo total gastrectomy. However, the entire course of the disease was similar, and anastomotic leak also occurred after surgery.
At that time, it was also a hospital-wide consultation chaired by Lin Ge. Because Director Kong was not at home to study abroad, Zhao Wenhua came. He was not sure about removing the stent for the patient after surgery, so he adopted conservative treatment.
The patient's chest was flushed every day to ensure smooth drainage. Just when everyone saw hope, the aorta next to the esophagus ruptured due to long-term corrosion by dirt and a sneeze.
That's why Ringer asked such a question.
Professor Lu also knew this patient. When he thought that the patient spurted out a mouthful of blood, he died immediately. The blood stains all over the house were scary to look at.
Later, because of this matter, several exchange activities were organized between departments, and Director Ye Qing Qiuye personally hosted them. After communicating with each other, the Medical Office made a guarantee, and Director Kong took over the job.
However, Director Kong’s level is still high and he is bold and careful. In the past few years, he has performed stent surgeries for anastomotic fistulas after esophageal cancer surgery without any problems.
Lin Ge was not in a hurry. He just looked at Quan Xiaocao next to Professor Feng curiously, wondering when she would speak and talk about the endoscopic surgery she wanted to do.
This is what medical technology is like. A few years ago, people who sneezed disappeared. For patients like this, who previously suffered from esophageal anastomotic leakage, they could only keep flushing, keeping it clean, and increasing nutrition to allow the anastomosis to grow.
This is where luck comes into play.
With interventional surgery, the survival rate of patients after being able to remove stents is much higher. Has Quan Xiaocao mastered any new technology? Even Director Luo was curious. Could it be some special skill secretly taught by Boss Zheng
Lin Ge's mind began to move.
But unlike him, Boss Zheng was not interested in this case at all and just sat there knitting red ropes. If he taught it to Quan Xiaocao, he would have to come and see if it was the first surgery.
Lin Ge was chatting while waiting for Director Kong to come, but he didn't see Quan Xiaocao talking. Not only did she not speak, she kept her head down, as if she didn't even dare to raise her head.
This kid is really cowardly, Lin Ge thought to himself.
But yes, if there were a room full of directors, professors, and her as a student, and she stood up and started talking, it would be Boss Zheng Ren instead of Quan Xiaocao.
"Dong dong dong~" There was a knock on the door.
Fang Lin opened the door immediately, and it was not Director Kong but Boss Zheng who came in.
"Boss Zheng, why are you here?" Fang Lin asked softly.
"Director Kong encountered some problems during the operation and asked the nurse to call me to attend the consultation." Zheng Ren said with a smile, "What's going on?"
After the trainee led by Professor Lu explained the patient's condition again, Zheng Ren took the film and watched it for three minutes and said, "Just with the next stent, the probability of recovery is still a bit low."
"There's no other way. I'll be satisfied if I can put the stent in firmly." Professor Lu said with a sigh.
"There's nothing wrong with removing the stent. I suggest you do an endoscopy." Zheng Ren said.
Endoscopy!
Boss Zheng proposed an endoscopy, which was completely different from what Quan Xiaocao said.
Director Luo asked with great interest: "Boss Zheng, Professor Feng's students also said they could do endoscopy. What kind of treatment is this?"
"Oh? Xiaocao has already started to get in touch with this area?" Zheng Ren glanced sideways at Quan Xiaocao and said with a smile, "Xiaocao?"
Quan Xiaocao responded like a mosquito, but still didn't raise his head.
Zheng Ren knew this guy's temper and was a little helpless. The surgery was clearly done well. According to Su Yun, the contact endoscopy treatment was considered a step into the hospital. Why didn't he even dare to say a word
"In recent years, there has been an endoscopic technology called over the scope clip. Simply put, the current main methods for treating anastomotic fistula include conservative treatment, conventional endoscopic clip closure of the fistula, and secondary surgery. However, due to conventional endoscopic The clamp closing force is small, the clamping range is limited, and the tissue around the anastomotic fistula is hardened or scarred, resulting in a low success rate of fistula closure." Zheng Ren stood in front of the reader, as straight as a steel gun.
“Second surgery and interventional surgery with stents are still the main methods to solve anastomotic fistula, but they often carry risks such as high recurrence rate and high mortality.”
"But I think this kind of over the scope clip should become the mainstream in the future. Now we are faced with the problem of insufficient surgical samples and no big data observation. Due to the lack of large-scale prospective clinical studies, the efficacy of OTSC anastomotic clip in treating anastomotic leakage is still Further research is needed to confirm.”
Professor Lu's ears almost stood up.
Although he had previously dismissed the words of the student taught by Professor Feng, the meaning of what Boss Zheng said had changed.
For thoracic surgery, if there is a way to solve the anastomotic leakage after esophageal cancer surgery, it means that the risk of surgery will be further reduced.
This is a great thing.
Although Boss Zheng also said that there is still a lack of large-scale prospective clinical studies, and the efficacy of OTSC anastomotic clips in treating anastomotic leakage still needs further research to confirm. But he could stand there and confidently propose endoscopic treatment because he knew it well.
Zheng Ren said this while staring at Quan Xiaocao.
"Xiaocao, come here and tell me your opinion." Zheng Ren said gently.