Famous Among Top Surgeons in the 90s -
Chapter 1034: 【1034】Teacher who cares about the apprentice
Chapter 1034: 【1034】Teacher who cares about the apprentice
If the tumor were only growing inside the vein, that would undoubtedly be the best outcome, a cause for universal celebration; the surgeon would simply need to remove that portion of the inferior vena cava.
There are various techniques for removal, such as if the tumor is sufficiently small, partial venous wedge resection could be performed, and the excised part can be patched with a synthetic vascular graft. If the length of the section removed is too long and cannot be patched, then autologous vessels or artificial grafts must be used for the transplant.
Among these, using autologous vessels is not a great choice because the inferior vena cava is thick, and it is difficult to find similar vessels within the body to use as a patch, leading to the common postoperative complication of the transplanted vessel being too narrow to meet the body’s needs, consequently causing other complications.
Is this tumor small? Definitely not, the patient has Budd-Chiari syndrome, which is clear evidence that the tumor is large enough to block the Porta Hepatis.
The surgical exploration has reached the critical step that will decide the patient’s life or death; it is necessary to investigate the condition of the hepatic veins. If the tumor is only blocking the opening of the hepatic veins, surgery is possible and requires only careful removal of this section. If the tumor has infiltrated the opening of the hepatic veins, then from a theoretical standpoint, surgery is fundamentally unable to completely remove it, meaning there is no need for the operation.
Teacher Lu’s breathing became deeper and quicker.
"It might be just an obstruction, not an infiltration," Yu Xuexian said.
Coming from someone in internal medicine who was looking at the surgical images, everyone in surgery knew that his statement was based on emotion, mainly out of consideration for Teacher Lu’s feelings present at the scene.
Receiving glances from those around him, Yu Xuexian deliberately said, "I could make a wager with you guys."
Upon hearing this, Zhu Huicang curled his lips and said that nobody would gamble on this matter with him. Because if you won the bet, nobody would be happy. If you lost, it was meaningless.
"What do you say your Cardiothoracic Department is preparing to do?" Yu Xuexian redirected the conversation, trying to distract Teacher Lu by asking about the surgical plan.
"To operate on the inferior vena cava involves the right atrium; of course, it necessitates contacting us in Cardiothoracic," Zhu Huicang said with an air of self-satisfaction and inevitability. A single incision in surgery affects the entire body, with the heart and brain being crucial, as they are the lifelines in one’s body, falling under two major specialties that no one can escape from.
"No, I’m asking specifically how your medical personnel plan to use that TEE in the beginning," Yu Xuexian clarified.
This question stumped Zhu Huicang. According to the original surgery plan drawn up by Fu Xinheng, as far as their department colleagues knew, there was no mention of this item.
The individuals in the back row from General Surgery Department Two were also pondering this question.
"Last time she didn’t mention this," Shi Xu remembered that Xie Wanying didn’t bring up TEE in her last briefing. Given her straightforward nature, she was not the type to withhold information during case discussions; she was the kind to speak her mind directly.
"There could be something that happened later that made her think of it," Tan Kelin finally spoke after a long silence, his voice as usual carrying a cold, professional edge.
Seeing him finally speak, everyone had the same thought flash across their minds: This man indeed cares for his prized student, only to speak up suddenly upon hearing an important topic related to Xie Wanying.
Something had occurred that made Xie Wanying think of TEE.
Xie Wanying had remembered her grandfather. TEE was a part of her prior planning, a test she had intended to perform on her grandfather in a few years, once she became a licensed physician.
Since Yangyang’s Mom didn’t have the same covert symptoms as her grandfather, initially, Xie Wanying had not thought to apply this test.
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