The anesthesiologist finished the anesthesia and returned to his small bench.

While writing down the anesthesia records, I secretly glanced at the young doctor in front of me who was looking around, and was said to be from a certain health center in central Vietnam. I felt a little disdainful and thought to myself:

"Oh, doctors from the countryside are just ignorant and are curious about all the equipment in the operating room."

In fact, Chen Qi was really wronged

Again, what has Chen Qi not seen in his two lives? The reason why he turned into a curious baby is to evaluate the development of medicine in this era?

Speaking of being advanced, you can tell who is the truly ignorant "hometown old man" after taking out the equipment in his space operating room.

This "exploratory laparotomy" is performed by Chen Qi, the first assistant is Zhao Chen, and the second assistant is two other junior doctors from the third department of surgery.

Xu Hongxing and Li Baotian also completed hand disinfection, wore surgical gowns and gloves, and were ready to go on stage at any time.

Especially Xu Hongxing, although he agreed to Chen Qi's application for teaching surgery, he was unsure. If there was an accident during the operation, he was ready to take over from Chen Qi as the surgeon at any time.

Zhao Chen had already laid out the surgical towel, nodded and said: "Dean Chen, the preparations for the operation are complete and you can start."

The anesthesiologist also said beside him: "The anesthesia is complete, the patient's vital signs are balanced, and we can start."

Chen Qi nodded and said in a low voice: "Okay, then I'll start, with the scalpel..."

Decades later, for such huge abdominal tumors, in addition to advanced CT and MRI positioning, the surgery will generally adopt a "laparoscopic" method.

Laparoscopic surgery has good lighting, better field of view than open surgery, is safe and reliable, and can provide more thorough tumor resection and dissection.

At the same time, it has the advantages of less trauma, less bleeding, faster recovery, less impact on the body's immune system, and shorter hospitalization time.

But in 1983, the world was still dominated by traditional surgeries. Hospitals that didn’t even have CT machines would be nice if they gave you an electric knife.

Chen Qi cursed in his heart, but still took a deep breath and began to concentrate on preparing for the operation. He made a longitudinal incision of about 10cm directly below the patient's umbilicus and to the left side.

Zhao Chen glanced at the surgeon, Chen Qi, a little surprised, and then at Director Xu behind Chen Qi.

In fact, many people in the operating room now look as surprised as Zhao Chen, because compared to the huge tumor, the 10cm incision is too small, so small that it is impossible to remove the huge tumor.

Many doctors are shaking their heads. Not to mention the level of surgery, the size of the incision shows that the level of grassroots doctors is not good enough.

Zhao Chen didn't have any bad intentions. While assisting in the operation, he asked doubtfully:

"Dean Chen, based on previous examinations, it is estimated that the diameter of this huge tumor is at least 30cm. With such a small incision, how will you be able to completely remove the tumor?"

Chen Qi did not raise his head, but still answered:

"Now we lack the necessary auxiliary examinations. Although the cancer indicators are high and there is fluid of unknown origin, we cannot easily conclude that the tumor is malignant. Otherwise, why would we need a laparotomy?

There are benign surgeries, and there are malignant surgeries. If it is determined to be malignant in the end, we can just expand the incision. But if I make a 30cm large incision at the beginning, the tumor will be benign in the end, and there will be more patients.

This surgery will affect your prognosis."

There is some truth to what Chen Qi said, and several older doctors nodded slightly in agreement.

The young doctors all scoffed and disapproved. The tumor index ca199 reached 2043u/l. How could it not be ovarian cancer? Is this possible for benign cysts?

Therefore, many doctors at the operating room once again expressed doubts about Chen Qi's ability, thinking that he could not understand tumor indicators. It is probably because Vietnam and China have not carried out this latest examination?

Chen Qi didn't know that he had been despised for n times. He was still pushing forward quickly. As soon as he opened the peritoneum and entered the abdominal cavity, a stream of pale yellow liquid flowed out.

Zhao Chen quickly used a suction device to suck up the liquid.

Chen Qi still didn't look up and ordered: "Take these liquids to the pathology department immediately for exfoliative cytology examination. The results will be reported as soon as possible."

At this time, a huge multilocular cyst appeared in front of everyone inside the surgical incision. Several assistants measured it and found that it was exactly as expected, reaching a size of 30. The upper edge almost pushed the spleen aside.<

/p>

Although the doctors behind were anxious to see the huge tumor up close, there were rules in the operating room. No one could get close to the operating table without the permission of the chief surgeon, otherwise it would cause contamination.

Li Baotian and Xu Hongxing were given preferential treatment. They were standing on the stepping cabinets and had a clear view from above.

Chen Qi wrapped the incision with gauze and started an abdominal examination.

Because this is a "teaching surgery", Chen Qi cannot remain silent like before. Now he needs to constantly explain each step and its meaning.

So in the quiet operating room, the only voice made by Chen Qi was:

"The tumor surface is smooth and has no adhesion."

"The tumor originated from the left ovary, and the lower edge of the cyst was densely adhered to the posterior wall of the uterus."

"The uterus is usually large, the right appendage is normal, and the right ovary is 2*2*1cm."

"The surfaces of the liver and spleen are smooth, and the surfaces of the peritoneum and intestines are smooth with no abnormalities. There are no obviously enlarged lymph nodes in the pelvis."

According to Chen Qi's report, the doctors in the operating room are all thinking, and each doctor has his own judgment.

After the abdominal exploration, Chen Qi decisively gave the final conclusion: "Teacher Li, Director Xu, I think this tumor is benign."

Xu Hongxing only said: "Chen Qi, Zhao Chen, please get out of the way first. Director Li and I will come and take a look."

Chen Qi and Zhao Chen put their hands in front of their chests, turned back to back with the two teachers, and stepped out from the operating table.

Xu Hongxing took over the position of surgeon, immediately checked the procedure again, and then nodded to Li Baotian opposite:

"Chen Qi, I support your judgment. It seems that the tumor does not look malignant. Don't move it yet and wait for the report from the pathology room before deciding on the next step of surgery."

At this time, a doctor who was watching couldn't help but asked:

"Dr. Chen, in the patient's preoperative examination report, the tumor index is very high, and not a little higher. Why do you insist that the tumor is benign now? When you chose the incision before, you said that it could not be ruled out as benign. How confident are you?

What is the basis for judgment?"

"Yes, this tumor indicator detection agent is imported from abroad. Foreign things should not be wrong."

"If tumor indicators don't count, then why do we still need to do this examination? Aren't we wasting our rich foreign exchange in vain?"

The doctors in the operating room suddenly started talking.

Chen Qi is a little strange.

Tumor indicators can only be used as a clinical reference or for dynamic observation, but they are by no means the basis for judging whether you have a malignant tumor.

This is basic medical knowledge that any junior doctor can understand. Why don’t the doctors in the First Affiliated Hospital of the Province not understand it?

Chen Qi asked Xu Hongxing next to him in confusion:

"Director Xu, how long has your First Affiliated Hospital been conducting this tumor indicator test?"

"Oh, this is a new technology we introduced from abroad last year. Now the hospital attaches great importance to this examination."

Chen Qi thought no wonder, he was deceived by foreigners, and some words were not explained clearly. There are also some young doctors who always think that the moon in foreign countries is rounder than that in China, so they think that tumor markers are the "gold standard".

"Director Xu, fellow seniors, I have also learned about tumor indicators from some foreign journals. You have a small misunderstanding about this. That is, the tumor indicators are only a reference indicator and cannot be regarded as a diagnostic indicator.

For example, this patient's carbohydrate antigen ca199 reached 2043u/l. Indeed, malignant tumors will cause hyperca199 syndrome, but certain benign lesions such as gastrointestinal inflammation, liver cirrhosis, etc. can also cause varying degrees of elevated ca199 levels.

.

Therefore, an occasional high CA199 test has little clinical significance. If the indicator continues to rise in a diagnosed malignant tumor, it means that the disease is progressing, the disease has relapsed, or the therapeutic effect after treatment is poor, which generally indicates that the prognosis is poor.

”

A young doctor was unconvinced: "Then if you say that the tumor markers are inaccurate, does that mean there is no cause and no need for clinical application?"

Chen Qi shook his head:

"That's not necessarily true. Some tumor indicators are very specific. For example, afp and alpha-fetoprotein can reflect well-differentiated hepatocellular carcinoma. Their increase is often earlier than clinical symptoms such as liver pain.

It can significantly improve the surgical resection rate and one-year survival rate of liver cancer. But then again, not all elevated AFP is liver cancer. For example, acute and chronic hepatitis can also increase AFP, but it is mostly within 300 μg, and often

Accompanied by increased transaminases."

Some junior doctors were dissatisfied and asked: "Dr. Chen, can you elaborate on the clinical significance of tumor indicators?"

"Yes, in clinical practice, tumor markers are first used to analyze the prognosis of patients with known malignant tumors, such as analyzing the degree of malignancy, invasiveness, spread, survival, etc.;

Secondly, those tumor markers that increase before treatment can be used to evaluate the efficacy during treatment, decide whether to change the treatment plan, diagnose whether there is any residual, and diagnose recurrence during follow-up;

Thirdly, patients with clear masses or metastases can be used for auxiliary diagnosis and tumor classification of tumor origin. Only individual tumor markers can be used for screening and early diagnosis of corresponding tumors during physical examination."

Chen Qi paused again when he said this, and smiled sheepishly:

"Our grassroots hospitals have fewer examination items, but your provincial hospitals are different. They prescribe more tumor drug indicators. This thing is highly profitable and can make money. It is much more than the few cents you make in registration fees. The director likes to prescribe examinations.

A single doctor."

Hehehe~~~~

Vote for recommendation

Previous chapter

Chapter Table of Contents

Next chapter
Chapter completed!