Start with the emergency physician

He Jianyi sighed and shook his head.

Zhou Yuan remembered his unlocked total gastrectomy.

“Teacher, maybe you can try total gastrectomy.” Zhou Yuandao.

“Nope. It has reached the advanced stage of gastric cancer, and the adjacent organs have also been invaded by gastric cancer, and there is no point in doing total gastrectomy. ”

He Jianyi frowned: “Moreover, total gastrectomy is a fourth-level operation, which is extremely difficult in itself, and only senior chief physicians dare to do it.” ”

“Ultrasound shows that only part of the adjacent organs are affected, and we can remove the affected organs together.” Zhou Yuan handed over the abdominal ultrasound.

Before the two finished discussing, Yang Wei’s wife crossed her hands and waved an X-shape, “No!” Without a stomach, what will my husband eat in the future! That’s not just death! ”

Zhou Yuan explained helplessly.

“The function of the stomach is really important, but it doesn’t mean much to your husband. In fact, the stomach only provides the mechanical function of temporarily holding and grinding food, and there is also a negligible digestion and absorption function. ”

This is a misconception that many people have about total gastrectomy.

Zhou Yuan said: “The digestion of food mainly depends on the small intestine, even if the total gastrectomy is performed, hunger will still be generated, and the digestive function of the intestine will not be affected.” After a total gastrectomy, there are many ways to rebuild the digestive tract. ”

“It can… Leave a little? Yang Wei’s wife asked cautiously.

Zhou Yuan shook his head helplessly: “We can only consider the long-term effect. Your husband discovered stomach cancer too late, and now you can only consider total gastrectomy. ”

“What will happen to my husband…” Yang Wei’s wife wiped her tears.

Zhou Yuan hesitated, but still chose to tell the truth.

“Patients with advanced stomach cancer will have a significant reduction in their quality of life. After that, hematemesis, melena, accompanied by anemia, weakness of the limbs and other symptoms. ”

“I already let him go to the hospital! I wrote that novel every day, and when I vomited blood, I said that I would update it! Whew…” Yang Wei’s wife sobbed.

“What about that? What else? Yang Wei’s wife planned to accept all the blows at once.

“Also, constant epigastric pain. After that, swelling and edema appear. The terminal stage is accompanied by symptoms such as loss of appetite, nausea and vomiting, and difficulty swallowing. ”

Of course, Zhou Yuan still had some words that he didn’t say.

In advanced gastric cancer, the cancerous cells will spread directly to the adjacent pancreas, liver, and transcolonic nodes, and there is also lymphatic metastasis to perigastric lymph nodes and distant lymph nodes, which can be judged by touching the left suprinal hard and inactive lymph nodes.

In addition, cancer cells can also metastasize to liver metastases, brain, bones, ovaries, etc. through blood circulation, resulting in symptoms such as ascites, jaundice, and large ascites in liver ascites.

The enlargement of the cancer itself can also cause complications such as gastric perforation, bleeding, necrosis, and obstruction.

In any case, in the advanced stage of stomach cancer, Yang Wei’s life is basically over.

Total gastrectomy is nothing more than a way to prolong life and improve the quality of life in the final stages.

Zhou Yuan mentioned again: “The five-year survival rate after total gastrectomy is about 20%, or you can choose chemotherapy to delay tumor recurrence and control tumor progression, but as far as your husband’s current situation is concerned, chemotherapy is of little significance, and if you do not carry out total gastrectomy, I am afraid it will not last long.” ”

“I see. Can I discuss it with my husband? Yang Wei’s wife lowered her head.

The door of the ward closed again, and Zhou Yuan caught a glimpse of Yang Wei sitting up in pain, and grimaced with himself.

“Teacher, what is your decision?” Zhou Yuan asked.

“There is a director of the gastroenterology department who is good at total gastrectomy, but he was invited to go to the provinces to operate on a cadre.” He Jianyi was a little embarrassed.

In hospitals, interns are subsidized by hundreds of yuan a month, and some hospitals that are worse also have interns who pay money. Residency doctors are only two or three thousand yuan, and there are several thousand for higher seniority.

Experts like this who fly around the country can get a salary of 120,000 yuan in a single consultation, which is a big gap.

Zhou Yuan looked at his three intermediate treasure chests and said, “Teacher, maybe I can.” ”

He Jianyi’s eyes lit up with the desire to be a suke, “Can you?!” ”

He didn’t understand a little.

Can you do a total gastrectomy, but not a gastroscopy?!

“You kid won’t let me practice gastroscopy, want to see my level!” He Jianyi was immediately happy and guessed.

Zhou Yuan smiled: “You are my teacher, how dare I!” ”

“Can you really complete a total gastrectomy?” After laughing a few words, He Jianyi became serious.

Seeing Zhou Yuan nodding, He Jianyi also nodded.

In this disciple, He Jianyi has seen too many miracles, and he is a little numb by now.

“Okay, call the ocean over.” He Jianyi said quickly.

It’s time for He Jian’s first-echelon doctor to study again.

After the preoperative examination was completed, Yang Wei’s body was completely capable of total gastrectomy.

Zhou Yuan also quietly opened the system panel.

Three intermediate chests disappeared and a brand new icon lit up.

“Get! Master Total Gastrectomy! ”

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