Chapter 1920 [1920] The Special
Chang Jiawei reckoned that the people from other departments sitting there, including his old classmate Fu Xinheng, might not be able to explain the content of their orthopedics department more fluently than what classmate Xie said just now.
Dr. Liu poked his head curiously, looked at classmate Xie Wanying, and asked her another question: "Tell him about en-blocresection."
This is because the senior has been whetted by her, and wants to discuss with her in depth. Anyway, after her speech, it happened to be able to continue to help them explain the family members, killing two birds with one stone.
"en-blocresection is a surgical concept. The surgical concept is not specific. It can be widely used to guide any surgical operation, not just spinal surgery." Xie Wanying said while trying to help Geng recall the relevant medical knowledge Point, "For example, the total cervical cancer radical resection we discussed in the gynecology department in the afternoon can be said to be an interpretation of en-blocresection."
Such an analogy is easy to understand. The others nodded frequently.
The direct translation of en-blocresection is: en bloc resection. This kind of noun does not have a designated front name, and it really does not refer to any particular operation, just like what Xie Wanying said is only suitable for any department of surgery as a concept and principle. A simple sentence sums it up as a full cut. No matter how much the tumor occupies, as long as the tumor occupies the entire anatomical area involved, it is completely resected.
The biggest advantage of total resection is self-evident, that is to minimize the problem of tumor spread during the operation. However, for patients and their family members, as long as they hear the words of cutting off all of them, they will inevitably be irritated, and it is difficult to accept the result of cutting off a whole piece for a while.
Doctors choose not to choose total resection, and they cannot depend on the mood of patients and family members. First, they must look at specific cases and discuss them separately.
Thinking of his stepmother's illness, he doesn't advocate cutting it all. Now my younger brother's surgery says that his younger brother's entire vertebral body will be removed, which is the spine. He is too clear about what it means to be missing a vertebral body. Geng Yongzhe's face was green, his heart ached, and he said, "Didn't it mean it was benign? Why did you have to cut all the vertebrae? Is there no other surgical method?"
Spine surgery is certainly like any other surgery, there are many surgical methods. For example, we often hear palliative and decompressive surgery that only removes the laminae for advanced patients, early curettage and resection surgery that only cuts the visible tumor part, and WBB staged resection surgery developed on this basis, see The scope of the quasi-tumor invasion was limited and the tissue was preserved as much as possible. However, later clinical practice has proved that staged surgery such as spine surgery does not always achieve good results such as breast-conserving and uterine-conserving surgery. Bone is a hard thing that is not easier to pathologically distinguish and cut than soft tissue.
"The spine is a special place. For tuberculosis of the spine, all vertebrae are cut. Doctors mainly look at the degree of bone destruction. If the bone damage is very large, it is almost the same whether you cut the whole vertebrae. On the other hand, whether it is benign or It is malignant. Because it involves the spinal cord, it is difficult for doctors to partially remove and remove it. Many tumors tend to recur. It is not a benign tumor that will not recur after cutting it. For example, the benign uterine fibroids we saw in the gynecology department. Your brother is young, and the doctor wants to relapse. It is better to consider the possibility of total vertebral resection. Even if it is malignant metastases, the possibility of all vertebral recurrence can be minimized." Xie Wanying explained to Geng.