Chapter 1909: with translation of chapter title

"What's there to hesitate about? Once the next rack is in place, everything will be ready." Su Yun said after glancing at the image.

Zheng Ren nodded, also agreeing with Su Yun's statement.

This situation, if an esophageal stent is not placed, the patient will quickly die from multiple organ failure due to inability to eat, within 1-2 weeks.

The reason it's uncertain is that, when near death, each person can endure for varying lengths of time.

After placing an esophageal stent, either it succeeds, allowing the patient to eat and not starve to death, or it fails, the heart stops, and the patient dies cleanly on the operating table.

Of course, this is just the logic of diagnosis and treatment. When it comes to life and death, these are major matters; rarely can one calmly judge according to logic.

The patient slowly dies, with no intervention; the family may just accept it. This is illness, this is fate.

But if a risky surgery is performed and the patient dies on the operating table due to a sudden complication, the doctor must bear responsibility. Director Miao…

This is part of medical risk.

"Old Liu, who is it?" Zheng Ren asked afterward.

"Zheng Lao Ban, the patient's son is a doctor at our hospital." Liu Zewei said: "It's said you've met before."

"Huh?" Zheng Ren froze for a moment.

"Once, on a plane, we encountered a patient with an aortic dissection; do you remember?" Liu Zewei asked.

"Remember." Such an experience only happened once; Zheng Ren certainly won't forget. Moreover, when leaving Hai Cheng, on the day Xie Yiren's birthday, Cui Heming's people came to help.

"The person who gave you the blood pressure medication and cuff on the plane, named Xia Hua, is the patient's son."

"Oh, that old man." Zheng Ren completely doesn't remember Xia Hua; he only remembers that when he boarded the plane, he encountered an old man with late-stage lung cancer.

"Lung cancer complicated with esophageal cancer has a low probability." Su Yun said: "But at this point, we can try a surgery. It would be best if your own family's doctors did it, as insiders, they'd speak plainly."

Liu Zewei smiled without speaking.

Zheng Ren felt there was nothing worth looking at in the image; he caught Liu Zewei's smile, froze for a moment, then asked: "What does Lao Gao mean? Is he asking me to do the surgery?"

"Hmm." Liu Zewei nodded: "Lao Gao wants you to come and use the Flying Knife to place the esophageal stent."

This procedure isn't major; Zheng Ren isn't particularly interested.

"Zheng Lao Ban, Lao Gao means to see if we can do double interventional treatment." Liu Zewei asked.

Double interventional treatment means placing a stent inside the esophageal lumen, plus an interventional embolization procedure.

While restoring esophageal patency, it also provides some control over the esophageal tumor.

"It can be done." Zheng Ren had already considered this possibility; he said without hesitation: "But Lao Gao could also do it, right?"

"There is a segment possibly involving the spinal cord supplying artery; Lao Gao doesn't dare to touch it." Liu Zewei said: "If he does it, it would probably just be a simple placement of an esophageal stent."

After explaining the situation, Liu Zewei smiled and said: "Zheng Lao Ban, I think Lao Gao wants you to make a trip, and incidentally test his surgery."

Zheng Ren gave a light smile.

Lao Gao also wanted to come to Di Du back then, but he had family matters and couldn't let go. Should he go back for a visit? And maybe check on Director Pan?

Just thinking about Director Pan, Zheng Ren's mind stirred.

The surgery at hand isn't difficult; if done carefully, there should be no problem. If worried, one could first do the interventional embolization procedure, wait until the tumor passes the necrotic congestive edematous phase, then do a second-stage stent placement.

These are nothing to Zheng Ren.

"Hmm, then you tell Lao Gao." Zheng Ren said: "If he discusses it with Xia Hua and can bear the surgical risk, that's fine."

"Good." Liu Zewei said cleanly and crisply, then with one hand rubbing his head and the other holding his phone, prepared to call Gao Shaojie.

"Old Liu, watching you rub your head every day makes me feel exhausted." Su Yun said: "By the way, are you especially envious of your own floor?"

"Huh?" Liu Zewei didn't understand.

"The hair on the floor is more than that on your head." Su Yun gave a hehe laugh.

"……" Liu Zewei gave a bitter smile.

This Yun Ge'er, his style is completely different from Zheng Lao Ban's; he seizes the opportunity to talk about his baldness, and he's long been accustomed to it.

【They say quickly write a love song……】

Zheng Ren glanced; it was Director Kong's call.

"Director."

"I'm here, please wait a moment."

After saying that, Zheng Ren hung up the phone.

"What's the matter?" Su Yun asked.

"They said there's a patient who wants me to take a look." Zheng Ren said.

Su Yun was curious, followed Zheng Ren, and the two went to Director Kong's office.

Knocking and entering, Director Kong was looking at an image.

"Zheng Lao Ban, come take a look." Director Kong said.

Zheng Ren glanced and saw it was an upper gastrointestinal contrast image, seemed to have a problem, so he immediately moved closer.

The contrast image showed: the esophageal mucosa lacked smoothness; the upper segment at the level of T4 vertebra showed localized narrowing; the upper segment was dilated; the lower esophageal segment showed a linear filling defect.

After swallowing barium, the barium in the mid‑lower esophagus split into two parts flowing into the gastric fundus; on the right side of the esophagus there was a small tubular barium shadow that wound its way upward from below and finally flowed into a small opening and re‑entered the esophagus.

"Huh? Double esophageal malformation?" Zheng Ren instantly became interested.

"Hmm." Director Kong said: "The books say it's a one‑in‑ten‑thousand chance, but I think the incidence is at least one in a million; I've only seen six cases in my lifetime, and this is the seventh."

"Should we do a surgical procedure?" Su Yun clenched his fists.

"The thoracic surgery people consulted me for a review, meaning they wanted a backup." Director Kong laughed: "If anything is missed, we'll still have to place a stent."

"The surgery isn't that hard either." Zheng Ren said while picking up the chest CT placed beside him and looking at it.

Chest CT showed a fine tubular structure shadow inside the esophagus, with enhancement similar to the esophageal wall; at the upper T2 vertebral level it shares a wall with the esophagus, and near the gastroesophageal junction it also shares a wall.

This is a typical image of double esophageal malformation.

"When will the surgery be done?" Zheng Ren asked.

"They said it's Ming day." Director Kong laughed and said: "Zheng Lao Ban, if you have time, go up and take a look?"

For this disease, Zheng Ren is the most suitable to see. Thoracic surgery Shou Bing and Intervention Department Shou Bing can both be performed. Intraoperatively, determine whether there is a risk of esophageal fistula after esophageal repair surgery, and whether a stent should be placed during the operation.

"What about Fang Lin?" Su Yun laughed and said.

"Professor Li's patient, I don't know if Fang Lin will perform."

"Well, I called Professor Li, this Shou Bing is scheduled for Ming day in the Hybrid Operating Room." Zheng Ren said: "The time estimate is a bit later; on my side I'm watching Fugui'er and them finish the TIPS Surgery."

Zheng Ren is cautious, wanting to watch Professor Rudolf Wagner finish the Shou Bing; Director Kong naturally won't say anything.