President Fei said: "I will introduce the patient's condition and surgical plan. The patient's female is a rural woman, forty-three years old, with abdominal pain and vomiting for two days. She went to their county township health center for treatment and was diagnosed with suppurative appendicitis. She was transferred to the county hospital for treatment and was subjected to appendectomy under epidural anesthesia."

"But after entering the abdomen, the appendix was not found. The cecum had a hard adhesion. The county hospital believed it was an appendix abscess and was preparing to incision and drainage after puncture. But it was not successful. Ask the superior doctor to come on stage and confirm that it was intestinal cancer. However, the county hospital had poor conditions and could not perform surgery. Contact us and transferred the patient to our hospital."

Kang Hong said: "The patient had just had an operation in the county hospital and was transferred here immediately. The road was bumpy, which may cause the lesions to spread. Has it been treated?"

Dean Fei said: "It was processed, the gauze was stuffed and the incision was sutured. Judging from the medical records transmitted, the left hemicolectomy should be performed. However, the specific situation will be determined after you come on stage. Lao Gu, it depends on you!"

Gu Jianguo smiled and said, "There's no way. I'm going to be on the shelves. It's thirty years ago when I was working on the general public. If the patient's nephew had to call me and asked me to go on, I really didn't want to go on it. But it doesn't matter. More than 40 years ago, it was in the 1970s and 1980s. When I first started the general public surgery, there were no good teachers. Everyone was looking at books and videotapes and fumbled over. Besides, you guys are there. It's okay, go on!"

Kang Hong felt a little scared when he heard this.

Gu Jianguo had already stood up and led the operation room, so he had to follow him and start preparing for the operation.

The circuit nurses and equipment nurses are from Kingsoft Hospital. Moreover, the equipment nurses are the head nurses.

It seems that Jinhua Hospital can be said to be using the strongest configuration. However, the strength of private hospitals is not in their own strength, but in having money to invite big names. However, this time the situation is relatively urgent and there is no time to invite big names. Only by asking Kang Hong, a little cafe, and using their strongest configuration power.

The patient was lying on the operating table with a general anesthesia with a tracheal intubation.

Gu Jianguo took a deep breath, slowly used the knife, and began the operation.

He cut the sutures, entered the abdominal cavity from the original incision, took out the gauze pad stuffed by the county hospital, and began to explore the abdominal cavity.

Kang Hong was shocked when he saw Gu Jianguo reaching out to check his colon. He quickly reached out to stop him.

Gu Jianguo was a little unhappy and asked, "What are you doing?"

"Director, the basic principle of tumor removal is to not contact the affected area of ​​the tumor. When exploring the abdominal cavity, you should first explore the liver and spleen, mesangial lymph nodes, etc., confirm whether other organs have metastases, and finally detect the lesions. It is not appropriate to directly detect the lesions."

Gu Jianguo's face changed and he said, "I used to do this when I was in general surgery."

"Thirty or forty years ago, it was not standardized at that time. Now it is standardized to avoid the spread of iatrogenic cancer cells."

Not contacting lesions is the basic rule of tumor surgery. Because the purpose of radical tumor surgery is to exhaust all possible and eliminate all cancer cells, and it cannot be left behind, and the cancer cells cannot be spread artificially due to the operation.

If this principle is not followed, first contact the tumor lesions directly, and then search for other organs, it is easy for hands that have been contaminated by cancer cells to metastasize the cancer cells to other parts, causing the spread of iatrogenic cancer.

Of course, Director Tao and Fei Tianhua, who are exposed to tumor treatment in general surgery, know this, but Gu Jianguo doesn't understand it because he has been experiencing external chests in the past thirty years, and all tumors in their hospital have been arranged to be treated in the oncology department, so he never comes into contact with tumor removal surgery.

The so-called separation is like a mountain, and he is not very clear about the basic principles of tumor removal surgery.

He looked at Dean Fei and Director Tao, and both nodded. Although he was very unhappy, he still obeyed and took his hand back in disappointment and began to check the liver, spleen, mesangial lymph nodes, etc.

After examination of liver, gallbladder, pancreas, spleen, stomach, duofacial intestines, no metastatic lesions were found, and several people breathed a sigh of relief.

Then explore the previously discovered mass at the cecum site.

This lump has a hard texture and enlarged mesangial lymph nodes.

Gu Jianguo looked at Kang Hong and said, "I think it should be a cecum tumor, what do you think?"

Under the detection of Kang Hong's perfect level insight, it was already accurate to determine that it was probably cecal cancer, so he nodded in agreement.

Gu Jianguo said again: "If you have no objection, then I will have a right half of the colon."

Kang Hong and Fei Tianhua both nodded.

Gu Jianguo began to separate and ligate the arterial veins on the colon and the right colon arterial veins, urinate the colon arterial veins, and the middle colon arterial veins. Then he pushed the colon to the right. When he was about to take the next move, Kang Hong suddenly signaled to stop.

Kang Hong said: "I think we should ligate the upper and lower intestinal segments with yarn, seal the intestinal cavity, and then perform intestinal resection."

"Why?"

"The tumor grows on the inner wall of the intestine. If the upper and lower intestine segments are not blocked, the cancer cells may fall off and spread in the intestinal cavity during the operation. The path of its escape must be blocked, and then the door is closed and beat the dog to prevent the spread of cancer cells. - Tumor surgery itself is not difficult. The most difficult thing is to completely clean the cancer cells and remove them without being completely removed. If the spring breeze blows, it will be meaningless."

Dr. Gu's old face turned red and said unhappily: "We had surgery back then, but we never had the upper and lower sections of the intestinal duct. Haven't we ever had it? We haven't seen many people relapse! You young, why don't you have any sense of responsibility? You are afraid of jackals in front and tigers in the back. How do you do things?"

Kang Hong said calmly: "Ancient, this is not a question of whether or not it is a question of whether the cancer cells can be completely removed. - For standard colon cancer surgery, the upper and lower intestinal ducts of the tumor must be tightened separately before freeing from the colon. In addition, the intestinal arteries and veins must also be ligated together, so as to avoid blood spread during the operation."

Gu Jianguo became even more angry and said, "Why are you so particular? What are you doing?"

Fei Tianhua hurriedly persuaded: "Lao Gu, just get the procedures as soon as possible. Just prick it. If you are not afraid of ten thousand, just be afraid of something."

Gu Jianguo was not upset and shook his head: "Okay, since you all insisted like this, then okay. Dr. Kang, come!"

Kang Hong started without saying a word and used hemostasis forceps to pass through the colon and small mesenteria in the avascular area about 20 cm from the ileum to the ileum, and each tied a yarn band to reveal the right mesenteria. Then, the superior colon artery, vein and right colon artery and vein were ligated at the root part to cut off the upper colon artery, vein and right colon artery and vein, ileum artery and vein, and the right branch of the artery and vein in the middle colon.

After the handling, he looked up at Gu Jianguo, who had a pale face, and thought that the old man was quite kind just now, but it was not the case when the conflict broke out. All expressions were written on his face. Fortunately, he did not have such a leader, otherwise he would have worn this little shoe.

Kang Hong said indifferently: "It's done."
Chapter completed!