Back in 2002 as a doctor

Soon the food and wine were served, and no one dared to persuade Mr. Huang not to drink, and no one would turn his eyes away.

As soon as this topic was over, Zhu Jun immediately began to talk about the specific situation of the patients admitted in the department, and "reported" to Mr. Huang.

Patients with high esophageal cancer after more than 20 years of surgery are indeed very rare. After Zhu Jun's carefully prepared few flattery, Huang Lao was not happy. Instead, Huang Lao felt a little regretful because Zhu Jun did not bring the film.

Watching movies while eating?

This was too casual, and Zhu Jun was a little aggrieved.

During the dinner, Zhou Congwen left for a while, full of wine and food for more than an hour, Zhu Jun proposed to arrange for Mr. Huang to stay first, but Mr. Huang refused.

When seeing a patient, one has to see the patient before the operation. Mr. Huang still sticks to his original intention like a little doctor.

It seems that if Zhu Jun hadn't arranged the banquet a long time ago, and he wanted to give the local snake a little face, Huang Lao would definitely go to the hospital immediately.

"Let's go, see the eye patient first." Huang Lao stood up after wiping his mouth, bowed his hands behind his back and walked out.

Zhu Jun's eyes fell on Zhou Congwen involuntarily.

He was even a little...envious that such a young doctor as Zhou Congwen was proficient in sycophancy, and he walked in the same gait as Huang Lao in the first place, what a fucking genius.

If you don't talk about this person, it's better to be thick-skinned than anything else. If I were young, I would definitely not lose my face and learn how to walk.

But Zhou Congwen walked out of the private room quickly, not knowing what to do.

"Mr. Huang, the patient has been thinking about you. She said that you extended her life by more than 20 years. I told her that if you come this time, you can extend her life by another 30 years!"

"It's about curing diseases, not prolonging life. I want to have that ability..."

While talking, he walked out of the private room, facing Zhou Congwen, carrying a plastic bag, which contained... boneless chicken feet.

"Boss, I don't want more, I want two." Zhou Congwen handed the plastic bag to Deng Ming, "Just go back and satisfy your hunger."

Deng Ming took the plastic bag and asked in surprise, "How do you know that?"

"I don't know." Zhou Congwen said perfunctorily, "His boneless chicken feet are a specialty dish, but they are too cheap to be served on the table. I was thinking that the boss must eat some special dishes when he comes to our place."

"Okay, okay." Huang Lao put his hands behind his back, and couldn't open his smiling eyes.His nose twitched, as if he had smelled the sauce of boneless chicken feet through the plastic bag.

Zhu Jun scolded his mother in his heart.

A meal cost him thousands of dollars, and Huang Laoxiao was never seen.Zhou Congwen bought two boneless chicken feet for a few dollars, but Mr. Huang...

There's no fucking reason for it!

"Xiao Zhou, thank you." Huang Lao said with a smile behind his back.

"hey-hey."

Zhou Congwen didn't expect to be able to buy chicken feet for his boss so soon. It's really hard to imagine what will happen in life.

When Zhou Congwen went to the grave in the last life, he would always take the boneless chicken feet, but now the boss is standing beside him alive, making Zhou Congwen a little dazed.

Walking out of the hotel, Liu Xiaobie leaned against the car door, and when Zhou Congwen came out, he made a princess hug pose.

Zhou Congwen really wanted to dig out a piece with his toes and stuff Liu Xiaobie in.

Damn haunted house, if I go again, my surname will not be Zhou.

"Mr. Huang, please..." Zhu Jun was interrupted by Mr. Huang just after speaking, "I'll take Xiao Zhou's car, see you at the hospital."

After finishing speaking, Huang Lao bowed his back and walked in front of Liu Xiaobie.

"Little girl, are you Zhou Congwen's girlfriend?" Elder Huang asked kindly.

"Yes." Liu Xiaobie said without hesitation, "Old Huang, please get in the car."

"You're welcome, I'll do it myself." Huang Lao smiled and opened the car door by himself and sat in.

"Xiao Zhou, you have a good eye."

Waiting for Zhou Congwen to get in the car, Mr. Huang said to Zhou Congwen.

"It's okay." Zhou Congwen's teeth itch when he thinks of Princess Liu Xiaobie's hug gesture, it's so embarrassing, but Liu Xiaobie still has to mention it every time.

"The patient's condition is a bit complicated, what do you think?" Elder Huang suddenly changed the subject and asked seriously.

"No surgery."

Zhou Congwen told the truth.

"Oh? Tell me." Huang Lao put his hands in front of him, glanced at the chicken feet in Deng Ming's hand, closed his eyes and said slowly.

"The anastomosis on the neck or the aortic arch itself is very difficult, because the anastomosis, poor blood supply to the thoracic cavity, gastric emptying obstruction, and high tension on the anastomosis can easily lead to anastomosis or thoracogastric fistula."

"24 years after the operation, the patient's anastomotic fistula was severely edematous. No matter whether it was thoracotomy or thoracoscopic surgery, there was no way to suture it. The knots could not be tied, and they would be torn as soon as they were tied."

Zhou Congwen sighed.

"If it were you, what would you do?" Huang Lao asked the school.

"I have no choice but to comfort the patient. Occasionally heals, but always comforts." Zhou Congwen shook his head.

There is actually a solution, and it is very simple - an esophageal stent.

Zhou Congwen is also very good at interventional surgery, but he doesn't know whether the esophageal stent has been opened or not, and he has just heard about the patient's condition.

For the current Zhou Congwen, there is indeed no way out.

"Well, there is no way under the old methods. This time Deng Ming brought an esophageal stent."

Zhou Congwen narrowed his eyes.

It was already 10 years later when he joined Huang Lao's family in his last life, and many businesses have already started. Zhou Congwen took over the Da Vinci robot.

As for operations such as esophageal stent grafts, which have long been routine, he doesn't know when his boss first carried out the new operation.

Unexpectedly, the boss had this awareness in 2002.

Indeed, when there were no stents a few years ago, anastomotic leakage in similar patients was equivalent to death.

Although there are some other methods, such as ignoring the anastomotic stoma, the patient suffers especially, and cannot eat, and can only beat chyme.

As for the survival period... don't talk about it.

It seems that the boss is thinking about how long the esophageal stent will take. Although he is not an interventional doctor, it doesn't matter whether the cat is black or white, as long as it can catch mice, it is a good cat.

No matter what kind of surgery it is, as long as it can cure the patient's disease, it is a good surgery.

"Boss, you are really amazing." Zhou Congwen praised him sincerely.

"Oh? You know about esophageal stents?" Deng Ming was even more surprised.

"I saw it introduced in foreign journals." Zhou Congwen fooled it quietly.

"Xiao Zhou, tell me what you think."

Chapter 0264 Emergencies

idea?What else can I think, as long as there are consumables, Zhou Congwen thought for a moment, but began to answer honestly.

"The People's Hospital doesn't have a DSA machine. Cardiac intervention is just about to start, and there's no hybrid operating table. But it's not a problem. If I choose, I can perform esophageal stent implantation under direct vision of a thoracoscope."

"There is a small nodule in the patient's lung, and the nodule can also be cut off by the way."

Huang Lao closed his eyes, twirling his thumbs back and forth, noncommittal to Zhou Congwen's suggestion.

"Okay, Doctor Zhou." Deng Ming smiled, "Tell me about your understanding of esophageal anastomotic leakage."

"Thoracogastric-tracheal fistula is a rare serious complication after resection of esophagus cancer, but the prognosis is poor, with an incidence rate of 0.3% to 1.9%."

Zhou Congwen looked back into the senior brother's eyes...and the bearded face, and said seriously.

"The clinical symptoms of fistula depend on the location and size of the fistula opening, and it often manifests as repeated respiratory tract infections. The typical symptoms of eating and coughing are rare, and sometimes they are ignored because of the mild symptoms."

"Director Zhu didn't ask about the medical history in detail. I guess the patient had symptoms related to anastomotic leakage a few years ago."

"If it was in the past, the sooner you know, the better, and there is still a chance for sutures. Once it progresses to the patient's current situation, it means death. But the boss is mighty!"

Zhou Congwen slapped a resounding flattery shamelessly.

Liu Xiaobie was a little surprised, this was not the Dr. Zhou Congwen Zhou she knew.Zhou Congwen in her heart is dull, unsmiling, and sullen.And the flattery just now was too blunt, it didn't seem like something Zhou Congwen could say at all.

Huang Lao said lightly, "I have seen too many patients with esophageal anastomotic leakage in my life. I have been thinking about what to do. If I can find a way, at least the average survival time of patients after surgery can be increased by more than one year."

"I started researching it in 1995. At that time, the stent graft was too hard and the effect was not good. And buying this thing requires foreign exchange, which is foreign exchange."

"..." Zhou Congwen was taken aback.

In his consciousness, there is no concept of foreign exchange at all.

"After joining the WTO, foreign device manufacturers came to my door. The first device I asked for was a stent-graft. Although I don't have a dsa system, I can do it in the radiology department. What do I need that device for?"

"You can still look straight at it." Zhou Congwen added.

Huang Lao nodded.

"Like the patient in front of me, if she had been like this a few years ago, I would comfort her and tell her to go home and prepare for her funeral. But now, she can live another 20 years."

Although Mr. Huang kept his eyes closed, when he said that he would live another 20 years, his eyebrows were beaming, as if he was tasting boneless chicken feet.

Liu Xiaobie followed Zhu Jun's car all the way to the inpatient department of the People's Hospital. When the car stopped, she got down immediately and opened the car door for Mr. Huang.

Zhou Congwen felt that Liu Xiaobie was so caring, she was Huang Lao's closed disciple.

"Mr. Huang, this way please." Director Zhu Junzhu didn't look at Zhou Congwen, and led Mr. Huang to the elevator.

The Thoracic Surgery Department of the People's Hospital is a bit noisy, and the corridors are densely packed with family members of patients.

Zhu Jun can't help it, he can't just clear the venue just because Huang Lao came.With so many family members of patients standing, it must be an emergency department.

But they are all doctors, and Mr. Huang has experienced several generations, so he should have been familiar with it for a long time.Zhu Jun bowed and peeked at Huang Lao.

Sure enough, Mr. Huang wasn't unhappy at all, and turned aside to let the patient's family members go inside.

As a clinician, I have long been familiar with the situation in front of me, and it is impossible to feel bored.If it is necessary to have emotions, it is possible to be curious. I am curious about what kind of patient it is and whether I have encountered similar patients.

"I'm the patient's uncle, I want to go in and have a look." A man stood at the door of the treatment room and said.

"It is enough to have one family member of the patient. So many people who come in are prone to infection."

"My sister knows nothing. I'm afraid you guys will fool her. I want to go in and have a look!"

The patient's family insisted.

Zhu Jun passed by without saying anything.

These are trivial matters, which have long been common in clinical practice.

People eat whole grains, and there are people with all kinds of tempers. It is difficult to plug in and know what is going on in their minds.

Glancing at the treatment room, a chest X-ray hung on the window, vaguely showing a spontaneous pneumothorax.

Zhu Jun didn't say anything, and took Huang Lao and his party into his office first.What made him a little disgusted was that Zhou Congwen from the Third Hospital also followed in carelessly, without any awareness.

This person is really annoying, but Zhu Jun didn't drive Zhou Congwen out.

Are you kidding, this is the person named by Director Deng himself, Zhu Jun doesn't want to make Mr. Huang and Director Deng of 912 unhappy because of Zhou Congwen.

"Old Huang, Director Deng, sit down first, I'll get the film. Let's watch the film first, and then go to see the patient." Zhu Jun said politely, and seeing that Elder Huang had no objection, he turned and went out.

The noise outside quieted down, presumably the doctor compromised and let the patient's own uncle into the treatment room.

This is inevitable, in fact, there is no need to insist, and it is not a matter of principle.

A few minutes later, before Zhu Jun came back, there was a shrill cry from outside, "Help!"

Zhou Congwen stood up subconsciously, raised his feet and ran out.At the same time, Deng Ming also made the same movement, and the two shoulders bumped into each other.

Before he could say anything else, Zhou Congwen pushed Deng Ming aside, opened the door of the director's office and ran out.

The family members of the patients outside the treatment room were a little confused. The door of the treatment room was shaking slightly, and there were crying sounds from inside.

Isn't it a patient with spontaneous pneumothorax?Could it be that there was a rare mediastinal flutter when the tube was inserted! ?

In an instant, Zhou Congwen had his own guess.

If it is fluttering mediastinum, then trouble!

Fortunately, the age of the patient does not seem to be very old, so there should be a possibility of being rescued.

It's really unlucky, although mediastinal flutter and cardiac arrest are items that must be accounted for in the closed drainage of the lower chest cavity, but in terms of the number of patients Zhou Congwen received, only a handful of cases have been seen.

I didn't expect today...

While running in quickly, Zhou Congwen pondered.