Chapter 1033 [1033] Rare Diseases

A big man confessed.

"The angle is also good, we can see clearly at a glance."

Live broadcast surgery is not a general surgery, not only for the surgeon to see clearly but also for the audience to see clearly. Think about the fact that the chief surgeon is a team of doctors, causing the mirror hand to randomly cut the camera. Even if the chief surgeon can't see clearly, he can understand the patient's condition based on pre-operative considerations, but the audience is different. Without the chief surgeon to understand the situation, he can only be on the sideline Look and know.

The importance of the hand mirror is reflected again.

It seems that this mirror holder is not only smooth in movement, but also skilled in playing skills, which should be at an intermediate to high level.

Doctors from other hospitals immediately understood: "Hmm."

Why did Tao Zhijie let a relatively rare female doctor into his team? It's not because of this. In fact, surgery does not exclude female doctors. As long as the female doctor's technical level is superhuman and strong enough, no one has the time to make irresponsible remarks.

The silence and admiration of this group of people proved that Xiao Xie had managed to speak with strength, and all kinds of inexplicable suspicions naturally disappeared.

The operation picture on the curtain was positioned at the inferior vena cava, and everyone could clearly see the lesion area there.

Teacher Lu coughed twice and said, "Looking at it this way, it's a primary inferior vena cava tumor."

Jiang Mingzhu handed over the thermos cup she brought to the teacher.

"No need." Teacher Lu waved his hand, probably not in the mood to drink water.

The results of the current surgical exploration are not ideal, and there is nothing wrong with it, so no one will be in a good mood.

It is not a metastatic tumor thrombus, but an extremely rare primary inferior vena cava tumor. The disease is said to be predominantly malignant, the most common being leiomyosarcoma of the inferior vena cava.

PIVCLMS inferior vena cava leiomyosarcoma, which is no different from metastatic carcinoma, also has a poor prognosis. Moreover, chemotherapy and other methods have little effect on it. If you want to prolong the survival period of patients, you can only take surgery as much as possible.

However, not to mention laparoscopy, traditional laparotomy is difficult to complete such an operation.

The origin of PIVCLMS is traced back to the smooth muscle of the IVC wall. Therefore, the wall of the inferior vena cava is thin, and the tumor cannot be stripped. Resection can only be performed. The scope of resection needs to include the inferior vena cava, liver, kidney, and surrounding lymphatic tissues invaded by the tumor.

Whether you only look at the scope of the disease, you can feel that the current operation is extremely difficult.

After all, the inferior vena cava is a large vein in the human body, and it is already super-long anatomically. If there is a tumor in it, it will be classified according to specialties, and multiple surgical specialties are not allowed.

According to this disease, some doctors theorized that the inferior vena cava can be divided into four segments from bottom to top.

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 hepatic hilum, the third segment is from the third hepatic porta to the diaphragmatic level, and the fourth segment is from the upper segment of the diaphragm to the right atrium. The first paragraph belongs to the category of urology, and the second may involve urology and hepatobiliary surgery. By analogy, the third section is mainly about hepatobiliary surgery, and the fourth section is about cardiothoracic surgery.

Going back to the current surgical case, the results of CT angiography, coupled with the obvious Budd-Chiari syndrome, indicated that the tumor obstruction mainly occurred in the third segment of the inferior vena cava, so the hepatobiliary surgery department was in charge.

At this time, the hepatobiliary surgeon should further clarify during the exploratory operation that the tumor is only growing in the vein, or growing outside the vein, or both.

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