Back in 2002 as a doctor

Ordinary people may forget that they are sick intermittently, but a doctor, especially a thoracic surgeon, deals with similar patients every day, and it is completely impossible to forget.

I am immersed in anxiety every day, even if I am not sick, I guess I will become sick every few months.

"I believe you know that even if there is only the last reason, you should still choose to have surgery. The pathology is benign, and it is a false alarm; if it is malignant, cutting it off so early is considered a recovery."

"After solving the problem of whether to perform surgery, the next thing is how to do it. There are two more points here. Let me talk about laparoscopic surgery first."

Zhou Congwen put his hands on the table and turned the lighter with his left hand.The lighter was like an elf, dancing between his slender fingers.

Looking at each other, Li Qinghua saw the bottomless water in Zhou Congwen's eyes, like a pool of brook water.

A stream of water and clouds.

"Traditionally, surgery for lung cancer requires resection of the lung lobe where the lesion is located and lymph node dissection.

However, because there are few lung CTs in clinical practice, and the resolution of X-ray plain films is very poor, most patients are discovered late.Even if the lymph nodes are completely removed, the postoperative effect is very poor.I believe that with so many years of clinical experience, you will have an intuitive experience. "

"The ground-glass nodules seen on CT are different. Generally, ground-glass nodules with little solid components are less malignant and grow slowly."

"Qinghua, don't rush to question it. We doctors must have reasons. I can show you the data in the "Lancet" to tell you why I said that, but you are only relying on the so-called clinical experience. "

Li Qinghua was taken aback.

Indeed, I only rely on clinical experience to judge, without a detailed theoretical basis.

In the demonstration operation performed by the Society, Li Qinghua actually did not approve of the operations performed by Professor Pan Chengpan and Professor Chen Houkun, and complained a lot.

It's not that the operation was not done well, but that they didn't clean up the lymph nodes.

From Li Qinghua's point of view, this is an irresponsible approach.And it is most likely because the use of thoracoscopic surgery is too troublesome, so the operator only chooses simple resection, and there is no way to perform lymph node dissection intuitively like thoracotomy.

at this time,

now,

When he heard Zhou Congwen say this, he was taken aback. Could there be relevant discussions in The Lancet?

The articles that can be published in the world's top journals must be a large-scale sample, and a few or a dozen cases can only be regarded as case reports.

No wonder Professor Pan Chengpan from the imperial capital and Professor Chen from the provincial capital both chose the same technique, but what they did...

"Thinking about the surgery?" Zhou Congwen asked.

Li Qinghua nodded.

"Although we know that small nodules can do this, there is still no conclusion in China. After all..." Zhou Congwen paused as he said.

It is now 2002, and there are not many laparoscopic surgeries in China, so they are very cautious.

In addition, I didn't want to be unconventional when performing public surgery, so I only chose a safe method.

"Let me tell you the conclusion first. For small nodules, lobectomy is not recommended, and only sublobar resection is required."

Hearing Zhou Congwen's firm words, Li Qinghua was a little confused.

Is this the little doctor's joke? Why should he say that to himself in a condescending tone?

Li Qinghua understood that the sublobar resection mentioned by Zhou Congwen included segmentectomy and wedge resection.It's just that thoracotomy is rarely done. Instead of doing this, it's better to cut the lung lobes directly.

"They are all thoracic surgeons. I won't explain the specific operation method to you. I suggest choosing a wedge resection from the outside to the inside."

While talking, Zhou Congwen put down the lighter in his left hand and picked up his mobile phone to fiddle with.

Li Qinghua felt faintly unhappy, didn't say anything, let himself guess?And it's a bit too much to play with your mobile phone in front of yourself.

But a few seconds later, the voice of the text message on the mobile phone rang.

"After all, it's a big deal, and they're all thoracic surgeons. It's useless to say what I say. You go back and check the information yourself." Zhou Congwen said, "There is a special topic in "The Lancet". You can refer to the data of the small nodules. I will send you the journal number, and if you are interested, go to the map to find it.”

"What about the domestic data?" Li Qinghua asked casually subconsciously.

"Domestic." Zhou Congwen smiled meaningfully.

Li Qinghua sighed, he knew the meaning of Zhou Congwen's smile very well.

domestic……

A few years ago, the diagnosis of lung cancer required a chest X-ray, and no small nodules could be seen at all.I can't even see it, how can I treat it?

In recent years, the hardware has changed rapidly. CT machines have begun to enter slightly larger hospitals, and people's hospitals have even entered machines that can perform thin scans and enhancements.

Seeing a doctor is not fortune-telling. Some diseases can only be treated if the hardware conditions are sufficient, such as small nodules in the lungs.

"Go back and have a look." Zhou Congwen smiled, looking into Li Qinghua's eyes with clear eyes, "I believe you can make the right choice."

Li Qinghua glanced at the text messages on his phone and nodded.

"Now, let me seriously talk about the relationship between you and Director Zhu."

Chapter 0196 Changing Life

I wish the director...

When Li Qinghua thought of his "master", he felt powerless.

"Director Zhu and Director Wang are people of the same era. Didn't you see what happened to Qinghua after the old Director Gong retired?"

Li Qinghua knew a lot of things about it, and when Zhou Congwen mentioned it, he thought about it carefully.

Things in the medical circle in the city are chaotic, but simple and simple.

In those years, Wang Chengfa drove all the old directors to the farm to feed the rabbits, and occupied the operating room to practice operations.

Later, when the old directors came back as kings, Wang Chengfa was kicked into a corner. If it wasn't for the establishment of the Third Municipal Hospital, he would have lived like this for the rest of his life.Let alone a thoracotomy, he couldn't even cut a lipoma.

After the old Director of Thoracic Surgery of the People's Hospital Gong retired, Zhu Jun took over. The first thing he did was to cancel the old director's expert clinic under the pressure of the hospital, so that the old Director Gong was completely cool.

Li Qinghua's cognition is very clear, and it is precisely because of this that the master promoted himself to be the director.He is kind and honest, and will never treat himself like he treated the old palace director.

But from Zhou Congwen's words, Li Qinghua heard a hint of other meanings.

"Director Zhu and the others rely on their skills the most. They think that as long as they live for a day, they can occupy that position as long as they have skills." Zhou Congwen sneered, "The story of the dragon-slaying boy who finally turned into a dragon will always be told. , It’s just that they thought about one thing wrong.”

"Technology?" Li Qinghua frowned.

"Technology has advanced too fast, and thoracotomy may not have changed much in the past few decades. If we have to talk about changes, there may be changes in details such as electric cauterization, rib removal, etc., but thoracoscopic surgery is a brand new existence. .”

"Are you sure?" Li Qinghua's heart moved, and he asked in a deep voice.

"I'm not sure it's not important, the key is what you think. You saw the demonstration surgery some time ago, are you sure?" Zhou Congwen said with a smile.

Li Qinghua was taken aback.

I really think that thoracoscopic surgery is less traumatic, but after all, it is rare, and he has no overall idea.

"Qinghua, you are already the chief physician. You have seen hundreds of thoracic surgeries. How would you say the thoracoscopic surgery is doing?"

Li Qinghua was silent.

He recalled the operation again at a very fast speed.

In fact, even though things have been busy recently, Li Qinghua's mind has begun to waver after seeing the demonstration operation.As long as you are not blind, you must know the benefits of thoracoscopic surgery.

But Zhou Congwen extended the surgical technique again... no, why did he come here.

Soon, Li Qinghua's thoughts were interrupted by Zhou Congwen's words.

"No matter how docile and humble you are, Director Zhu will never let you have even one operation. Don't make excuses for yourself, even if you have spent countless efforts on it over the years." Zhou Congwen said lightly.

Li Qinghua lowered his head and remained silent.

He knew that Zhou Congwen was telling the truth, but every time Li Qinghua thought of this matter, he would involuntarily resist this thought.

"Actually, you also know it, but the relationship of these years and Director Zhu's constant promises make you always want to wait." Zhou Congwen's eyes suddenly sharpened, as if piercing Li Qinghua's soul.

"I also know that Director Zhu will definitely tell you that he will personally perform a thoracotomy and cut off the upper lobe of your left lung. To be fair, he has no intention of harming you. The surgery is his skill. The limit of ability."

"But, there are obviously better choices, why don't you choose?"

"You gave Zhu Jun a bit of face, but the price is your own body, a lung, is it worth it?"

"He will let you operate? Are you sure?"

"Stop dreaming, Qinghua."

Li Qinghua didn't know, but Zhou Congwen knew very well that Zhu Jun's practice was called pua in his previous life.Wang Chengfa played it this way, and Zhu Jun played it the same way.

Zhou Congwen's words are like knives, every sentence kills the heart.Li Qinghua's face was pale, he knew very well what Zhou Congwen said was right.

Even if I saved enough face for Director Zhu Jun, at the cost of being cut off a lung lobe, the possibility of finally allowing myself to undergo surgery is very small.

"Qinghua, are you speculating in stocks?"

"Ah?" Li Qinghua shook his head.

"Stop loss is very important. You are in your prime now, so why hang on to Zhu Jun's tree."

"..." Li Qinghua looked miserable, "Congwen, I decided to go to cardiac surgery six years ago, and the current level of surgery..."

"Demonstration surgery, how is Professor Chen's thoracoscopy?" Zhou Congwen asked.

Li Qinghua nodded, "Okay, very good."

"Come to the Third Hospital, and within half a year I will teach you how to do thoracoscopy. The level is no worse than that of Professor Chen."

"!!!"

Li Qinghua made an exclamation mark.

"No kidding, I'm telling the truth." Zhou Congwen smiled, "This is a big deal, I won't force you to make a decision, go back and check the information first and then think about it yourself."

"Congwen, it's not that I don't believe you..." Li Qinghua asked hesitantly, "Why?"

"Because I'm young." Zhou Congwen said with a smile, "I'm different from you. Wang Chengfa and I don't have a good relationship. It's okay for me to leave as soon as I want, but usually when I can do it, I will never force you." , I can’t get out the unconvinced feeling in my heart after walking like this.”

"..." Li Qinghua looked at Zhou Congwen's clear eyes, and it was hard to imagine that all he did was just for Wang Chengfa.

"Wang Cheng discovered that he is still the head of the department, and he is still one step away from the deputy director acting as the director. I think his greatest wish is to become the deputy director and then retire."

"If you come, Chief Physician, you are in the prime of life, and the surgery needs to be performed well, why is there no reason for the hospital not to allow you to be the Chief Physician? It is reasonable in terms of organizational procedures and technical level."

"And do you have a lot of connections?"

When it came to connections, Zhou Congwen's smile grew even wider.

"Are you sure I'm... I've got pulmonary nodules now..."

"Small problem. The tube was extubated on the second day after thoracoscopic surgery, and recovery exercises can be performed three days later without the sequelae of chest tightness and shortness of breath. Even..." Zhou Congwen looked at Li Qinghua with a smile.

"Even what?"

"The lungs can regenerate, although it's not as obvious as the liver. Maybe ten years later, when you take an X-ray, it might not be obvious that you've had a wedge cut."

Li Qinghua understands the truth.

But he never thought that such a good thing would happen to him.

"Okay, I'll stop here. You've been in a mess recently, but I suggest you think about it more, and don't take chances."

Li Qinghua looked at Zhou Congwen blankly.

"Please trust me, or trust your intuition. Even if you cut the lobes of your lungs, it will definitely not help your future."

"I'm going first, please think carefully."

Li Qinghua was almost persuaded by Zhou Congwen, he hesitated for a moment, and suddenly asked, "Congwen, if I don't go, how will you deal with Director Wang?"

"Aren't you coming? Why? Would you rather have a lobe of your own lung cut?" Zhou Congwen asked.

"..."

"Don't worry, even if you don't come, I still have other ways."

Chapter 0197 Orthopedic Consultation

Zhou Congwen didn't urge Li Qinghua to make a decision either, and left the private room directly after speaking.

Today is Shen Lang's class, Zhou Cong Wenqiao came out of class to meet Li Qinghua in a tight schedule, so he had to go back and make some appointments.

Absenteeism and being late are different concepts, and the patient Zhou Congwen feels uncomfortable if he doesn’t take a look before leaving get off work, which is a part of obsessive-compulsive disorder.

Back in the Third Hospital, he quietly went to change clothes and check the wards. The patients were all stable. Zhou Congwen saw that Shen Lang was looking up at the sky thinking about something, so he walked over and asked, "Shen Lang, have you started writing yet?"

"Writing now." Shen Lang lost his previous high spirits and said with a sad face.