Vol 3 Chapter 2694: Postoperative anastomotic fistula


"Oh." Zheng Ren answered, but didn't seem to have any interest. Just an anastomotic fistula, there is no need to look up. If 912 cannot solve this problem, it will not be the top three hospitals in China.
Linger said, "Then I went up to boss Zheng."
After that, he turned and left.
On the way, Linger's mind was full of pictures of Boss Zheng making red ropes. This person is really interesting. Every time he went to the surgery, it seemed that he could watch the film with his arms over and over again.
Not to mention anything else, this serious effort alone is admirable.
And all of them won the Nobel Prize. It seems that he is not ready to rest, and is full of energy to prepare for his clinical life.
I really don't understand him, but that's fine, it's good for myself. I had already arrived at the Science and Education Department, and saw that the position of Deputy Dean beckoned to myself after a few years.
The thought of this made Ringe happy. Just now, the confusion in the heart caused by the inexplicable wrong operation gradually faded away, and he took a brisk step to the chest surgery.
Linger thinks that this consultation of thoracic surgery is nothing special. For example, the following hospital has performed surgery and transferred to 912 to continue treatment. There are almost every day. I do n’t know what thoracic surgery thinks. Attend the consultation.
However, he is unwilling to put too much head on it, think more about the needs of Boss Zheng, think more about how he can benefit himself.
The consultation time is three o'clock in the afternoon, a few minutes early, which is also Linger's habit. For this consultation, he has been away for a while at the medical commission.
After entering the doctor's office, Linge saw Feng Jianguo and Director Luo were there.
Ok? How could there be so many people? Ringer was a little surprised. When a member of the medical department saw Linge come in, he gave him his place immediately.
"Director Luo, why are you here?" Linge asked in amazement.
"Hehe." Director Luo smiled and said, "I'm not here for consultation, just to see the excitement."
Linger sat upright all of a sudden, he felt a vague sense of something wrong. Thoracic surgery, digestive medicine, it seems that only in the esophagus, cardia section intersection. And Feng Jianguo was there, and there was a female doctor with her head down.
It was Quan Xiaocao, and Linge smiled, and he whispered, "Cory is no one, Ye Chu is going to deal with a medical dispute. Everyone is busy. I got the news from the medical consultation committee and hurried back. Yes, I don't know yet. "
"A patient with lower esophageal epigastric, gastric fundus, and gastric body cancer underwent radical total gastrectomy + esophagus-jejunum Roux-en-Y anastomosis after neoadjuvant chemotherapy for gastric cancer. The patient has been having fever after the operation, Considering that there might be an anastomotic fistula, isn't this coming. "Director Luo said.
If it is reluctant, it has something to do with digestive medicine, but this is too reluctant.
Ringer still didn't understand the question, but he didn't ask, and kept listening.
"The chest department has been doing thoracic irrigation and drainage, pondering about the second-stage surgery. Later, the student of Lao Feng said that endoscopic treatment can be performed, Xiaofang asked me, and I came to see with curiosity."
Endoscope? Director Wei's Gastrointestinal Surgery recently applied for some scientific research projects, including endoscopy. Now that Ringer is in charge of science and education, he knows it.
But scientific research projects are just projects, and it will take time to implement them concretely. Lin Ge can't believe the blink of an eye can be used in clinical practice.
"Director Luo, what do you think?"
"Director Lin, I just took a look at the patient's condition, and the condition is not good." Director Luo said, "CT showed that the left pleural effusion accompanied the formation of pus cavity, and CT guided left pleural puncture drainage + left subcondylar With puncture drainage, about 10ml of light blue sputum-like liquid was drawn from the left pleural pus cavity, and about 20ml of yellow-green liquid was drawn from the left subphrenia. "
"Light blue? Yellow-green?" Ringer frowned.
This infection is too heavy.
Color means bacterial infection, yellow-green is more common, and light blue is rare. What bacteria are light blue? After thinking about it for a long time, Linger didn't want to understand.
"I made a gastroscope in the morning ..." Director Luo said, "In the beginning I felt the risk was high, so I refused. Later Gu Lao looked for me, but I couldn't help it.
"Gastroscopy revealed an anastomosis of the esophagus and jejunum at a distance of 38 cm from the incisors. A fistula was seen on the left front wall of the anastomosis, and an anastomosis was seen at the edge, about 0.8 cm in diameter."
"What about this situation?" Linger asked.
"If in the past, you could only strengthen nutrition, avoid infection as much as possible, and allow the patient's esophageal fistula to heal as quickly as possible. As for the long and short, it depends on your luck. Do you know the biggest problem with surgery for esophageal cancer? Right on the fistula. "
Ringer nodded.
"It is now possible to place a stent to prevent reflux of gastric juice. However, the length of the stent is also a problem if it is exposed to light. Professor Feng said that he could be treated with endoscopy." Director Luo once again mentioned Quan Xiaocao.
It's a bit interesting. Gastrointestinal surgery is to reverse the rhythm of some of the business areas snatched by digestive medicine. Linger made a judgment in his heart.
No wonder Director Luo took the initiative to look at the situation.
What the directors thought was in Linger's mirror. As long as the treatment is not delayed, whoever is responsible for the specific business will certainly not care.
It has nothing to do with yourself, anyway, it's all the meat in the 912 cauldron. You can do whatever you want, as long as you don't give trouble to Lao Tzu.
But this time it involves Quan Xiaocao. Linger knows that Quan Xiaocao has published several SCI articles in the past six months, all of which have Su Yun's credit, but Su Yun did not leave a name.
He smiled slightly and decided to just talk and talk less.
Fang Lin came in with a sweat ~ EbookFREE.me ~ Seeing that Lin Ge was here, he came over and said hello seriously. People with the medical office can't smile hippie, especially if there is serious business.
This patient belongs to Professor Lu. Fang Lin was just arrested and worked for Zhuang Ding. He greeted him and hid in the corner, waiting for the consultation to begin.
The doctors under Professor Lu started to introduce the condition, which was no different from what Luo said, but it was more detailed.
"This is the case for patients." Professor Lu said, "After 10 days of closed drainage drainage of the thoracic cavity, the esophageal fistula did not improve a little. The next treatment is better, and the rest can wait for the patient. He heals slowly after returning home. "
"It's very difficult to get off the stent. Why didn't the interventionist come?" Linger asked in his heart.
"Director Kong was invited to the consultation and said that there was an emergency operation there, and Director Kong came to power." Professor Lu said, "I discussed with Mr. Gu. The best way is to take a certain risk to make a stent. Actually, not after surgery. By one month, the chances of problems with stent surgery are too high. "
He said, making a helpless expression.
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