Start as an Emergency Physician

Chapter 210 Cesarean section or tumor removal first?

The blood supply to the tumor is derived from the internal iliac artery.

This means that only the main internal iliac artery needs to be blocked, and the tumor will be ischemia, and the probability of intraoperative hemorrhage during tumor removal surgery will be greatly reduced.

"The deputy director of the first obstetrics department is here!"

Wei Lili walked into the conference room with He Jing.

The two of them were also invited by Zhou Yuan.

Giant fibroids can cause abnormal fetal position during pregnancy, and intrauterine growth retardation, placenta lowering or previa, etc.

During childbirth, uterine fibroids may cause obstruction of the birth canal, difficulty in descending the fetal presentation, and may also cause uterine contraction weakness and prolonged labor and postpartum hemorrhage.

In general, pregnant patients with fibroids can give birth spontaneously without urgent intervention and prevent postpartum hemorrhage.

However, He Lili's condition is very special, the huge fibroid hinders the fetus from descending, and a caesarean section must be performed at this time, otherwise the fetus cannot be delivered normally.

"With such a large tumor, there is no problem with fetal development... It's incredible!" Wei Lili looked at the results of the examination with a surprised expression.

"Doctor, you can't remove my uterus, I'm only twenty-one years old!" He Lili was very scared.

Wei Lili frowned and said: "The current situation, the only thing that is clear is that a cesarean section must be performed, as for the cesarean section at the same time, whether to remove fibroids or perform hysterectomy at the same time, it needs to be decided according to the size and location of the fibroids and your situation..."

"I also thought it was too difficult to remove fibroids. Wei Lili hesitated for a long time, and finally gave this answer.

Zhou Yuan frowned.

"Ladies and gentlemen, the angiography shows that the blood supply of the tumor comes from the internal iliac artery, which is easily blocked, as long as the artery is blocked for resection, there will generally be no intraoperative hemorrhage. Compared to tumors that come from multiple arterioles, this tumor is easy to resect..."

Zhou Yuan's words stunned everyone present.

The head of the oncology department sighed and said, "We have noticed it too, but what we are most worried about is the damage to the fetus. "

Lu Shao's eyes lit up and said, "You said that this tumor is easy to resect, do you mean you can remove it?"

Zhou Yuan smiled helplessly.

Click on the system.

"System, exchange for master myomectomy. "

A large amount of information poured into Zhou Yuan's mind.

Uterine morphology, various structures of the uterus, types of tumors, classification of the capsule, and more.

and the details of the operation were also quickly imprinted in Zhou Yuan's mind.

After a moment, Zhou Yuan felt his fingers become strong again.

Every time he is improved, he will give Zhou Yuan's whole body muscles a new shape to suit a certain operation, and after so many master surgeries, Zhou Yuan has no problem doing some surgeries outside the system.

"I was confident that the giant fibroids would be removed with both the patient and the fetus. Zhou Yuan said directly.

Those present were stunned.

Especially Lu Shao, it was like seeing a ghost.

"Can you really do uterine muscles?!"

He just asked, what Dean Fang said before was right, skull separation, double lung transplantation, and severed finger reconstruction... Knowing just one of these is enough to walk sideways in the medical world.

Zhou Yuan is not only fully proficient, but also proficient!

He didn't expect Zhou Yuan to see more, but now Zhou Yuan told him that he could also do surgery on the side of obstetrics and gynecology tumors...

He Jianyi and Dean Fang were also stunned for a few seconds.

"Zhou Yuan, if you can do it, I will immediately arrange someone to cooperate with you. Dean Fang was full of trust in Zhou Yuan.

Zhou Yuan nodded: "It's okay for people from anesthesiology and obstetrics and gynecology to stay." "

Dean Fang waved his hand to the two directors of the Department of Obstetrics and Gynecology Oncology and the Department of Oncology: "You can leave." "

Deputy Director of the Department of Obstetrics and Gynecology Oncology: ...

"Can't the two of us just sit around and watch?"

"Yes, if the two of us can learn something from such a difficult operation, it will definitely be beneficial to our department!"

The eyes of the two directors completely changed.

If you do a good job in surgery, who doesn't want to go up and learn from the experience when you see a surgical expert?

Zhou Yuan's temptation for them was too great.

Zhou Yuan smiled.

Two deputy directors, maybe two intermediate treasure chests again!

"Dean Fang, let the two directors stay as well, they specialize in tumors, and I may need the help of the two of them at that time. "

Dean Fang nodded directly: "Okay!"

Next, Zhou Yuan discussed some surgical procedures and plans with everyone.

The main question is whether to have a cesarean section or remove the tumor first.

In the end, the result obtained is simultaneous.

If the tumor is to be removed, Zhou Yuan must block the blood supply to the uterus, which means that the fetus will be in danger, so there can be no fetus at this step.

However, if the cesarean section was performed first, Wei Lili and He Jing could not successfully remove the fetus in the uterus with huge fibroids.

Therefore, the final plan is for Zhou Yuan to cut off the blood supply to the uterus during the operation, temporarily make the huge fibroid deviate, separate from the fetus, and make enough intrauterine space for cesarean section.

After the fetus is successfully removed, Zhou Yuan will perform the next step of tumor resection.

Soon, a series of preoperative tests were completed.

He Lili's mother had a hard time signing the informed consent form for the operation.

The informed consent form for surgery has a series of risks written on it.

Like what:

1. In the process of waiting for labor, although the medical staff have taken routine measures to monitor the fetus, there are still rare cases where unexplained fetal distress suddenly occurs, and fetal movement disappears, which then leads to fetal death.

Second, the patient is treated according to the obstetric operation routine, and a very small number of mothers will have drug poisoning due to personal reasons... Trigger death.

......

......

The more He Lili's mother looked at it, the more frightened she became.

"Isn't it just a cesarean section! Why is it so dangerous, you have to die or live at every turn!"

Zhou Yuan silently handed over another form and said, "There is also an informed consent form for myometrial myomedectomy here..."

Any accident is either the death of the fetus or the death of my daughter, and you doctors are not responsible at all, and we will have to bear it ourselves in the end!"

Zhou Yuan understood He Lili's mother's mood and explained: "These are all accidents that may occur during the operation, but the probability of occurrence is particularly low. And we have video recording of the whole operation, if there is an accident, it is the responsibility of our doctors, and in the end, our hospital will definitely be responsible. "

He Lili's mother was still a little scared.

At this time, He Lili was pushed out and prepared to go to the operating room.

Seeing that her mother was still hesitating, she smiled hard and said, "Mom, I believe in the doctor!"

Feilu reminds you: there are three things to read - collection, recommendation, and points