A big guy confessed.
"The angle is also good, we can see it at a glance."
Live surgery is not an ordinary surgery. It is not only necessary for the main surgeon to see clearly, but also for the audience to see clearly. Thinking that the chief surgeon is a team of doctors, so the hand holding the mirror cuts the lens at will. Even if the chief surgeon can't see clearly, he can understand the patient's situation based on the preoperative thinking, but the audience is different. Without the chief surgeon understanding the situation, it can only be on the side of the scene See and know.
The importance of the mirror hand is once again reflected.
This mirror-holding hand seems to be not only smooth in movement, but also skilled in playing skills, which should be at a medium to high level.
The doctors in other hospitals immediately understood: "Hmmmm."
Why Tao Zhijie let a relatively rare female doctor into his team, not because of this. In fact, surgery does not exclude female doctors. As long as female doctors are super-skilled and strong enough, no one has time to make irresponsible remarks.
The silence and admiration of these people confirmed that Xiao Xie had spoken with strength, and all kinds of inexplicable suspicions disappeared naturally.
The surgical screen on the screen was positioned on the inferior vena cava, and everyone could clearly see the lesion area there.
Teacher Lu coughed softly and said, "Looking at it this way, it is a primary inferior vena cava tumor."
Jiang Mingzhu handed the thermos cup he brought to the teacher.
"No." Teacher Lu waved his hand, probably not in the mood to drink water.
The results of the current surgical exploration are not ideal, not that there is nothing, so no one is in a good mood.
is not a metastatic tumor thrombus, it is an extremely rare primary inferior vena cava tumor. This disease is said to be malignant in most cases, the most common being inferior vena cava leiomyosarcoma.
PIVCLMS inferior vena cava leiomyosarcoma, which is no different from metastatic cancer, and also has a poor prognosis. And chemotherapy and other methods have little effect on it, if you want to prolong the survival of patients, you can only use surgery as much as possible.
Unfortunately, not to mention laparoscopy, traditional open surgery methods are difficult to complete such operations.
The origin of retrospective PIVCLMS is in the smooth muscle of the IVC wall of the inferior vena cava. Therefore, the inferior vena cava vein wall is thin, and the tumor cannot be peeled off, and only resection can be performed.
Whether you only look at the scope of the disease, you can feel that the current surgery is extremely difficult to do.
After all, the inferior vena cava is a large vein in the human body, and it is anatomically too long. If a tumor grows in it, it should be divided according to specialties, and there should not be multiple surgical specialties.
Some doctors have theorized that the inferior vena cava can be divided into four segments from bottom to top according to this disease.
The first segment is to the level of the renal vein, the second segment is from the opening of the deep vein to the third porta hepatis, the third segment is from the third porta hepatis to the plane of the diaphragm, and the fourth segment is the upper segment of the diaphragm to the right atrium. The first paragraph belongs to the category of urology, and the second paragraph may involve urology and hepatobiliary surgery. And so on, the third stage is mainly about hepatobiliary surgery, and the fourth stage is about cardiothoracic surgery.
Returning to the current surgical case, the CT angiography results showed that, coupled with the patient's obvious Budd-Chiari syndrome, the tumor obstruction mainly occurred in the third segment of the inferior vena cava, so the hepatobiliary surgery was responsible.
The hepatobiliary surgeon needs to further clarify during the exploratory operation that the tumor is only growing inside the vein, outside the vein, or both.
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