Chapter 736: The Big Brother

Two 100-inch large screens lit up at the same time.

One of the screens is a video conference consisting of 4 pieces of picture-in-picture, and the other screen has a screen saver at this time, ready to be used to play the required video and other information at any time.

Lloyd, who had changed into a surgical gown, had hair on his arms and chest, arguing fiercely with the four doctors in the four videos.

"From the information you provided, the degree of differentiation of the tumor is not low, and it is very likely to be a poorly differentiated tumor. In this case, I suggest expanding the scope of resection. In addition, in terms of the current requirements of the patient, whether it should be considered Liver transplantation? If liver transplantation can be done, the survival time can be greatly improved."

"The patient has no conditions for liver transplantation. Chinese hospitals are very conservative in organ transplantation, and there are very few sources of organs. This patient is neither eligible for a donor nor has the money for such a major operation..."

"Since this is the case, I don't think the scope of resection should be expanded. However, the location of resection can be reconsidered. Is the resection location chosen now too cautious? Only part of the left liver is resected. The resection location is also very strange. The chief surgeon How does your doctor think about this?"

Lloyd followed the doctors in the video to discuss for more than ten minutes. When he turned around, he saw Ling Ran, who had been watching the MRI film for a long time, facing the empty wall, waving his arms, as if he was simulating the operation process.

Lloyd frowned and asked, "Doctor Ling, would you like to join us?"

"How to join?" Ling Ran was still busy doing the simulation, so he only took time to answer.

Looking at Ling Ran's back, Lloyd said, "You can stand next to me, and we can discuss this operation together."

"Okay." Ling Ran did not resolutely resist.

Overall, Lloyd's help is good for patients.

The four experts involved in the teleconsultation he convened were all well-known surgeons, and it can be said that they had a wealth of theory and experience.

In fact, even MD Anderson Cancer Center usually does not convene four senior experts for remote consultations. Two or so experts are already very face-saving. Because MD Anderson Cancer Center is a world-class medical center, they not only aim at local telemedicine, but also conduct systematic teleconsultation for areas with underdeveloped medical level. Therefore, consultation resources are quite tight.

However, after Lloyd's emotional explanation, the four remote consultation experts were extremely serious.

Knowing that Ling Ran was the chief surgeon, the four of them just admired Ling Ran's handsomeness and age, and then quickly got to the point:

"Dr. Ling Ran, can you explain your surgical approach? The pre-resection you chose is relatively small, but it involves many sections. From what I saw just now, there are posterior inner segment, anterior inner end, and right anterior segment. The outer segment, the lower inner segment...the bile ducts and blood vessels involved are also very complicated, if this is the case, is it better to directly perform liver segmentectomy?"

"Liver resection, too many cuts, I'm afraid the patient won't wake up." Ling Ran didn't hide his thoughts. If the other party had a better surgical plan, he didn't mind adopting it. In fact, Ling Ran still had some expectations. , the four plus one expert in front of him can give him good advice.

Because of this, Ling Ran did not hesitate to tell the reasons for his encouragement and decision.

Ling Ran was originally unwilling to undergo surgery for liver cancer, but now he chooses to do it out of the interests of the patients. Therefore, Ling Ran hopes that he can do well, and the better he does, the better. Compared to this consideration, Ling Ran He doesn't care much about right or wrong or reputation.

Unless there is a fundamental change in cancer treatment, Ling Ran will not perform frequent cancer operations, and his reputation in this area is not in his consideration.

The four experts on the screen were collectively silent for more than ten seconds when they heard Ling Ran's words.

"It is true that more liver segments will be resected, so how many liver segments should be reduced?" The previous experts frowned and made suggestions.

"These several liver segments have been invaded by cancer cells,

If the scope of resection is reduced, the cut will not be clean. " Ling Ran replied.

"Indeed... However, if the survival goal is 3 years, it will be safer to use this method."

"It's too arbitrary to say three years now."

"It's not necessary to make such a compromise for the sake of liver segment resection."

Ling Ran also said: "Three years is indeed the patient's request, but we still hope to achieve a better result."

"It's pretty good to be able to reach 3 years. How big is the tumor? It's 8 centimeters, right? It's not bad to survive. 3 years is the expected value."

8 cm sounds ordinary, but in the doctor's world, liver tumors larger than 5 cm are difficult to deal with. Because of the rich blood supply of the liver, large tumors are often connected with many blood vessels. Not to mention the devastating consequences that may be caused by any disturbance during the resection process, even if the resection is successful, the liver will be occupied by a large number of useless cancer cells The organization, what remains, is also being tested.

As a doctor, you have to consider the availability of the remaining liver tissue, and the problem of diffusion during the resection process, and then you want to cut it clean...

In general, the worse the patient's physical condition, the more issues to consider and the worse the prognosis.

It is very difficult to get a good prognosis for an 8 cm liver tumor. The reason why Ling Ran is willing to perform this operation is also the same. According to his judgment, the patient who was handed over to He Yuanzheng for liver resection should be able to survive the operation smoothly, but after the operation, there is nothing to be expected.

With He Yuanzheng's technique, a little inattention may cause the patient to fall into a hepatic coma. Even if this is not the case, the subsequent weakness will make the patient feel more painful during chemotherapy. Whether he can survive it will be a huge question. test.

Chemotherapy may cause patients to be bedridden for a long time, and may even stay in bed for about a year. At the same time, the recurrence of cancer may destroy their last hope...

Ling Ran didn't need to explain, the doctors present all knew the most likely direction of the operation.

It is precisely because of the extreme difficulty of the operation that Lloyd called the doctors for remote consultation, otherwise, he alone is enough to give advice.

Ling Ran stood opposite the screen, listening carefully.

It has to be said that in some small aspects, Anderson's experts can put forward quite constructive opinions. Considering their identities and their suggestions, the old man who first proposed liver segment resection is likely to have a master Level liver resection technique, and the other three are not necessarily masters of liver resection, but their attainments in general surgery or cancer will not be low.

However, if it is just remote assistance, a master liver resection leader cannot rely on language to give decisive help.

He himself may be proficient in segmental hepatectomy and has a lot of experience in the prognosis of patients, but Ling Ran is not a doctor who grew up in the era of segmental hepatectomy. His master liver resection is not the liver. Segment resection.

On the other hand, Ling Ran, who also possessed a variety of master-level and perfect-level skills, may have surpassed the old man on the other side of the screen in terms of this surgery alone.

Therefore, after a brief consultation, Ling Ran decided to start the operation, still using his own method, with only minor modifications.

"In this case, the risk is still very high."

"Lloyd, I'd rather you send the patient to Anderson."

"We might be able to get a foundation to do that."

Several doctors chattered on the screen, but Ling Ran's face gradually became serious: "Scalpel. Turn down your voice."

"Yes." Ling Ran's surgery team started operating without hesitation.

For Ling's current treatment team, experts and scholars at the MD Anderson Cancer Center are just decorations.

Hepatectomy, Ling Ran is the boss!