On Monday afternoon, Dr. Liu went to the Department of Thoracic Surgery for a routine preoperative visit.
Walking while looking at the surgical information from the thoracic surgery department: male, 79 years old, esophageal cancer…
He was thinking: Wouldn’t the thoracic surgery really require surgery? Or, is this a minimally invasive surgery for a small lesion? It stands to reason that the risk of major surgery at this age is still very high. Regardless of him, as long as surgery dares to do it, there is no job that anesthesiologists dare not take.
However, after seeing the medical records, he suddenly felt that it was not that simple: the patient’s tumor extended from the middle and lower esophagus to the cardia. This means that, if surgery is required, these have to be cut off.
If they are all cut off, what can be used to replace the esophagus?
Accompanying surgery to challenge all kinds of difficulties all the year round, Dr. Liu knows very well that the stomach is used instead. Simply put, the stomach is lifted up and docked with the esophagus.
But then, you have to open your chest!
Some people will ask, how can you “open your chest” when you open your chest?
This is because, with the increasing popularity of thoracoscopy, most surgeries can be Minimally invasive surgical solution under the laparoscope.
Although he has not performed anesthesia for major thoracotomy for a long time, Dr. Liu is not worried, but is slightly worried about the patient’s recovery after surgery.
With mixed feelings, Dr. Liu went to the hospital to do some anesthesia-related physical examinations for the patient.
Dr. Liu felt relieved when he saw the patient himself. Because the elderly usually have the habit of exercising. Every morning, I go for a walk in the mountains. The so-called “walking”, according to him, young people can not drive him.
Able to walk on the mountain, it can almost be judged that his cardiopulmonary function reserve is very good . After inspection, it is really good. To this end, Dr. Liu is more confident.
In order to ensure that the operation of the elderly is foolproof, Dr. Liu carefully inquired about the history of various diseases of the elderly. Even the eating and sleeping habits of the elderly have been understood.
In the middle, the family also once asked a question that almost caused the operation to “abort”: Can this operation be avoided?
To be honest, the current medical environment really makes patients ask this question. If you insist on doing it, the problem is not easy to solve.
However, considering the old man’s condition, his esophagus has been partially obstructed. If surgery is not performed, people will soon die due to nutrition and other problems. As for how long they can live after being cut off, no one can say for sure.
After careful preparation, the surgery officially began.
During the operation, although the old man was in good health, there were still some cases small situation. For example, when a surgeon is concentrating on an operation, his hand is accidentally pressed against the heart.
You might just skip a few premature beats if you’re young. But in the elderly here, first beats prematurely, and then obviously arrhythmia. If you don’t stop calling, there may be big problems.
In this way, after Dr. Liu called to stop and slow down several times, the operation finally completed the most critical anastomosis stage.
In this operation, the cooperation in the chest closing stage is also very important. In the most critical stage of “expansion of the lung”, Dr. Liu gently squeezed the ball with his hands. He knew that if this step was rushed, it would likely lead to recruitment pulmonary edema in the lungs. If so, the patient is at risk.
When the chest doctor finished the last stitch, he looked down at the chest bottle beside the bed and asked Dr. Liu: How is it?
Don’t worry, there is no leakage, and the color is not red.
Simple questions and answers, everyone is relieved to hear.
Next, it’s up to Dr. Liu.
Dr. Liu had already made full preparations because he was worried that the elderly would wake up slowly. In the past, general anesthesia was enough for thoracotomy. In this operation, due to the age of the patient, Dr. Liu added a paravertebral block to the general anesthesia.
In this way, the problem of surgical pain is completely solved. During the operation, there was no pain signal transmission, and Dr. Liu controlled the anesthesia to a slightly deeper heat than deep sedation, which also laid the foundation for early postoperative recovery.
After 10 minutes, the old man showed physical activity. Seeing this, Dr. Liu hurriedly called the old man’s name, and the old man nodded lightly.
After the successful extubation, the old man asked “Did you do the surgery?” which made everyone feel full of accomplishment. A few hours of fatigue, swept away.
Outside the corner, Dr. Liu also saw the surgeon’s pointComplimentary look.
Many times, success is just a matter of hard work. The success of this operation is inseparable from the mutual support of the department of surgery and anesthesiology, and it is inseparable from the 100% trust of the patients and their families. May the old man live well for the rest of his life!
【Warm reminder】Please pay attention, here are a lot of professional medical science, to reveal the secrets of surgical anesthesia~