Li Qinghua was silent.

He also knew what his master was thinking.

But he has invested too much in recent years, so that completely denying it is equivalent to denying himself for the first half of his life, and he can't do it no matter what.

This requires cruelty. Li Qinghua is now in trouble with internal and external affairs, and his mind is full of confusion.

"Did you participate in the learning in the provincial capital last time?" Zhou Congwen asked.

Zhou Congwen's thoughts were very leapsy. Li Qinghua didn't keep up for a while. He was stunned for a few seconds before he said in a deep voice, "I've participated. I know that Professor Chen's laparoscopic surgery is the one you matched with. The surgery is done well, especially well."

"Yes." Zhou Congwen smiled faintly, "You should have seen two shots, even one shot."

Li Qinghua nodded.

"This is not the point. I think your surgery can be done, rather than cutting the lung lobes." Zhou Congwen said lightly.

His words were very soft, but when he heard it in Li Qinghua's ears, he was stunned for a moment.

Wedge cut refers to retaining the lung lobe, cutting only a triangle, and cutting off the location where the tumor or small nodule is located.

If the wedge stomatization is performed, the lung function will not be affected after the operation, and the gap between it and lobular stomatology is completely different.

But...is it really possible? Li Qinghua was stunned by Zhou Congwen's words and fell into confusion.

"Let me talk about the technical matter first." Zhou Congwen smiled slightly, "The mainstream view now is the first ground glass nodule found. As long as it is not very large in size and density, it can actually be followed up for a period of time."

"But the small nodules on the upper lobe of your left lung are 8mm in size and have a low density. Because you are a doctor, I recommend cutting them out directly."

The last sentence was a bit abrupt. Li Qinghua was stunned for a moment, but then he understood what Zhou Congwen meant.

He is a doctor, and Zhou Congwen is afraid that he will think randomly every day.

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

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

"I believe you know that even if there is only one last reason, you should choose to have surgery. The pathology is benign and a false alarm; if it is malignant, it will be cured if you cut it off so early."

"I solved the problem of whether to perform surgery or not. What is the next thing to do. 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, jumping between his slender fingers.

With eyes facing each other, Li Qinghua saw the clearness in Zhou Congwen's eyes, like a pool of streams.

A stream flows water and clouds.

"In the traditional sense, surgery to treat lung cancer requires removal of the lesions in the lung lobe and lymph node dissection.

However, because there are few clinical CT and the resolution of X-ray flat films is very poor, most patients find it late. Even if the lymph nodes are thoroughly dissipated, the results after surgery are very poor. I believe that after so many years of clinical experience, you will have a careful experience."

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

"Qinghua, don't be busy questioning it first. We should be reasonable and well-founded as doctors. I can now use the data from "The Lancet" to tell you why I said that, and you are just relying on the so-called clinical experience."

Li Qinghua was stunned for a moment.

Indeed, I only make a judgment based on clinical experience and have no detailed theoretical basis.

During the demonstration surgery learned, Li Qinghua actually did not agree with the surgery of Professor Pan Chengpan and Professor Chen Houkun and Professor Chen Houkun, and he complained a lot.

It’s not that the surgery was not done well, but that they didn’t clear the lymph nodes.

From Li Qinghua's perspective, this is an irresponsible approach. And it is very likely that the thoracoscopy is too troublesome, so the surgeon only chooses simple resection, and there is no way to perform lymph node dissection intuitively like thoracic surgery.

at this time,

now,

He was stunned when he heard Zhou Congwen say this. Could it be that there is a related discussion in "The Lancet"?

Articles that can be found in the world's top journals must be large-scale samples. A few cases, and more than 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 they did...

"Are you thinking about the public operation?" Zhou Congwen asked.

Li Qinghua nodded.

"Although I know that this can be done in the small nodule, there is still no conclusion in China. After all..." Zhou Congwen said, pausing.

It is now 2002, and not many laparoscopic surgery is being carried out in China, so they are very cautious.

In addition, I don’t want to be innovative when the surgery is open, so I only chose a safe approach.

"I'll tell you the conclusion first. For small nodules, lobectomy is not recommended. It only requires sublobectomy."

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

Is this a little doctor joking? Why did he say this to himself in a condescending tone?

Li Qinghua understood that the sublobectomy surgery mentioned by Zhou Congwen includes two types of surgery: segmental resection and wedge resection. However, the thoracic surgery is performed less frequently. Instead of doing this, it is better to directly cut the lobes.

"We are all thoracic doctors. I won't explain the specific procedure to you. I recommend choosing a wedge resection from the outside to the inside."

Zhou Congwen said as he put down the lighter in his left hand and picked up his cell phone to fiddle with it.

Li Qinghua felt a little unhappy and said nothing, asking him to guess? And playing with his phone in front of him was a bit too much.

But a few seconds later, the phone text message sounded.

"After all, it's a big deal, and they're all thoracic surgeons. What I said is useless. You go back and check the information yourself." Zhou Congwen said, "There is a special topic in the Lancet. From 1998 to the present, a lot of data about small lung nodules can be referenced. I'll send you the journal number. If you are interested, go and save the picture and find it."

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

"It's in China." Zhou Congwen smiled, meaningful.

Li Qinghua sighed, he knew very well what Zhou Congwen meant.

domestic……

A few years ago, I judged that lung cancer would require chest radiographs, and I couldn’t see the small nodules at all. I couldn’t even see them. How to treat them?

Hardware changes have been rapid in recent years. CT machines have begun to enter slightly larger hospitals, and the People's Hospital has even entered machines that can do thin sweeping and enhancement.

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

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

Li Qinghua glanced at the text message on his phone and nodded.
Chapter completed!