Surgery Godfather-Chapter 273 - 0257: Did the Surgery Fail?

Chapter 273: Chapter 0257: Did the Surgery Fail?

The magnetic resonance imaging results of Sisi’s post-operative check-up one week later showed that the liver metastases had slightly shrunk. The edema was more noticeable than before, evenly distributed, its edges perfectly tracing the original outline of the tumor.

This type of MRI manifestation shows that at the time, the focused ultrasonic waves provided a full-dimensional bombardment of the tumor, without any omission or exceeding the tumor’s range, achieving the goal of precision targeting.

However, even so, there would still be residual tumor cells. These cells slowly divide and eventually return, a fate shared by all advanced malignant tumors. Once distant metastasis occurs, it is almost impossible to eradicate them completely.

That is why the principle of “early detection, early diagnosis, and early treatment” is advocated for tumors. When the cancer cells have not yet spread and are confined to a local space, they can be completely removed with a single surgery.

Duan Xiaoming from the Gamma Knife department had been closely following this patient as well. Since the patient had undergone surgery in their department, he also had the authority to access the case.

He was curious about the surgery performed by Yang Ping that day. He casually fired several dozen ultrasonic waves and made meticulous adjustments to the parameters, pushing the precision of the machine to its limits. Was he just putting on a show, or was he actually skilled?

...

Duan Xiaoming wanted to know the answer. Sisi also had an MRI scan that day, but it was right after the surgery and the imaging was not very clear, so it was still too early to reach a conclusion.

Now, Duan Xiaoming is convinced. Comparing the pre-operative, intra-operative, and one week post-operative MRI images, the effect is very clear. No one understood the effectiveness of the surgery better than Duan Xiaoming – it was very good, too good to believe.

From the MRI images, the liver tumor had been completely targeted by the focused ultrasound, and the high temperature had killed most of the tumor cells, which were now collapsing and being absorbed.

As a specialist in the Gamma Knife, he himself had never really believed in its potential. He had applied several times to transfer it back to the ultrasound department, but the hospital had refused.

After all, the hospital had spent so much money on this equipment, they couldn’t just let it sit idle. At least for now, it could be used on patients with uterine fibroids.

Thus, with the department barely surviving, Duan Xiaoming was passing his days idly, spending most of his time watching stock market fluctuations on his phone.

“Isn’t it strange that Dr. Yang, an orthopedic specialist, can also perform Gamma Knife surgeries?” Since there were no patients at the moment, his assistant, a resident, asked during their casual conversation.

Duan Xiaoming pointed it out to him, “See, look at the MRI of that little girl from their orthopedics department. The liver tumor was cleaned up so well by the Gamma Knife.”

If the Gamma Knife could have this kind of effect, then there is great opportunity for his future. He wouldn’t have to just drift along aimlessly as he’s been doing.

Duan Xiaoming thought that if he could learn this remarkable technique from Dr. Yang, he could make both fame and fortune simply by treating uterine fibroids, never mind other diseases.

Given his situation, if he wants to make a name for himself, he would need to focus on a niche field and excel in it.

Tackling liver or lung cancers would be too challenging. Instead, he planned to make a name for himself by specializing in uterine fibroids, securing his place amongst the medical professionals in G City.

Duan Xiaoming considered how to network in the field, knowing he’d probably need Song Zimo’s help again.

Since the machine was just sitting idle, he thought that if there were any future patients, he could invite Dr. Yang for the operation and learn from him, instead of obsessing over his stocks at the cost of swollen eyes and a lighter wallet.

He needed to pull himself together and focus on serious matters, Duan Xiaoming thought as he rubbed his bald head.

—

“Does it still hurt here?” Yang Ping asked, pointing to the location of the right hepatic region.

“It hurt a bit on the day of the surgery, but it’s not painful now. I feel much better. Thank you, big brother.” Freed from the agonizing hepatic pain, Sisi was looking much better.

On her desk was a “Human Anatomy Atlas,” People’s Health Publishing House edition. Beside the book were drafts of anatomical sketches.

“I borrowed this from Sister Feifei. I want to become a doctor too, so I’ve started preparing now. This is the liver that I drew. Sister Feifei said to learn anatomy well, you have to be able to sketch.”

Seeing Yang Ping’s attention drawn to the book on her desk, Sisi explained proactively and proudly showed him her sketches.

The drawings, though a bit crude, were well done. Upon closer inspection, Yang Ping found them quite detailed: two halves, five lobes, eight subdivisions, the gallbladder, the hepatic duct, the common hepatic duct, the common bile duct, the proper hepatic artery, and the portal vein were all portrayed.

This little girl might truly have the makings of a good doctor, Yang Ping thought, feeling a sudden pang of emotion.

“You’ve done very well!” Yang Ping praised her.

Pleased with herself, the young girl said: “I want to draw every part of the human body and then create a complete human anatomy illustration.”

The disappearance of postoperative hepatic pain also confirmed the effects of the operation. The heat energy from the surgery had largely killed off the tumor, which was now beginning to be absorbed and shrink, and the tension on the liver’s capsule sensory nerves gradually eased, naturally reducing the pain.

This was the first time Yang Ping had used the simulation operation function of the system space, and the result was very good. Complete simulations of Sisi’s tumors had already been carried out and so far, only the liver operation had been performed. Surgery to treat tumors in other parts of the body will be done in stages in the future.

This simulation function is very beneficial for complex surgeries. It allows for extensive research and experimental procedures to be carried out on replicated patients, supplying data that can then be applied to actual cases.

This ability to create replicas of patients can be used flexibly, such as for dissection, which can reveal diseases that medical equipment cannot detect.

—

Fang Xiaoyun’s muscle strength was still deteriorating; it had now reduced to level two. She could only move around in bed and was even unable to lift her leg.

The parabolic span of this spinal cord edema is a bit large and doesn’t quite correspond with the patient’s condition. Yang Ping asked Zhang Lin to perform another magnetic resonance imaging (MRI) scan on Fang Xiaoyun, including vascular imaging.

Could it be that the spinal artery is blocked again? Or is there a hematoma causing pressure? Did the surgery interfere with the blood circulation of the spinal cord?

Interfere with the circulation of the spinal cord? Impossible!

Yang Ping was very confident in his operation. Not a single intercostal artery had been severed, so how could it have damaged the blood circulation?

Hematoma can also be ruled out because if there was a hematoma, it would definitely have shown up in the MRI.

However, another arterial blockage is entirely possible. The MRI’s diagnostic accuracy for these minute changes is 95%, meaning there is still a 5% chance of missed or misdiagnosed cases.

To others, there might be a 5% chance for error, but Yang Ping doesn’t have such a high margin for mistake.

He had recently undergone training in system space auxiliary examination. His ability to read MRI scans had improved substantially. He could recognize artefacts, interference, imaging deviation, etc. If there were any doubts, he could always further examinations or opt for other methods of examination to diagnose accurately.

“The peak of the swelling should have passed. Why does it persist for so long and why is her muscle strength getting worse?” Song Zimo was perplexed.

“MRI wouldn’t make a mistake in recognizing the edema. This patient is intriguing. Why is there no sign of the swelling subsiding even after entering the plateau phase?” Yang Ping was also somewhat puzzled.

“If it’s just due to the spinal cord edema, it’s not a big deal. We can wait a bit more; the worry is if there are other reasons,” Professor Zhang also chimed in.

“Doctor Yang, Fang Xiaoyun’s mother is here. She was brought up by the security guards. She wants to see her daughter. The guards asked if she can?” Head Nurse Cai Qiaojun came over and reported.

Two security guards brought Fang Xiaoyun’s mother. This time she was not making a fuss. She was calm and seemed like an honest person. She kept apologizing, “I was too emotional last time. I understand now. I just want to see my daughter. She is in the hospital for surgery, isn’t she? I’m her mother; I want to take care of her.”

If she wasn’t causing any trouble, there was no reason not to let her take care of her daughter. Yang Ping told Head Nurse Cai, “Ask the patient herself. If she agrees, let her in.”

They don’t have time to deal with her, as everyone was busy analyzing the patient’s condition. In these kinds of cases, one small oversight could potentially lead to permanent paralysis. Thus, once there were signs of abnormalities, they had to be analyzed and dealt with in a timely manner.

“We’ve already used Methylprednisolone and 20% mannitol, but the edema did not diminish. It makes no sense, right?”

Zhang Lin, the attending doctor, also joined in the discussion.

“There could be two reasons for the situation. One, it could be related to thoracic tuberculosis, or two, it could be unrelated and due to other factors. Normally, we simplify diagnosis to explain symptoms with one disease. But when that doesn’t work, we consider multiple factors. Could this patient have other issues?” Yang Ping proposed.

Diagnosing a patient is a process of logical reasoning, utilizing one’s knowledge and experience, combining a patient’s history, examination results, and auxiliary examination to peel back layers until the truth is revealed.

However, for many cases, the actual cause can’t be determined. They can only provide symptomatic treatment. For some diseases, they even get cured before the cause is revealed. This is a very common occurrence.

It’s like when the television images are blurry, you give it a knock, and it becomes clear. You don’t know the actual reason.

“There’s no indication of spinal cord ischemia, no need to worry excessively. We can wait a little longer. If she really can’t recover, we may need to look from other angles. It might be too early to start rolling out examinations now; the patient can’t afford them financially,” Professor Zhang suggested waiting for a while longer.

Yang Ping thought for a moment, going over all potential causes in his mind. Currently, Fang Xiaoyun’s MRI does not show signs of spinal cord ischemia, and the main arteries supplying the spinal cord do not appear to be blocked either.

At least, the major arteries visible in the MRI aren’t blocked; the arteries without contrast do not have a significant impact on blood circulation and wouldn’t pose a threat, even if they were blocked.

Multiple reviews of the D-dimer test show a downward trend. This doesn’t support the possibility of the spinal arteries being blocked and suggests that the blood clot is confined to a small area caused by the surgery.

At the moment, starting extensive tests might be a tad early because these tests can have certain side effects.

“Professor Zhang is right. We can wait a bit longer, observe closely. I agree too,” Yang Ping made the decision.

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“Let me go and check on her!” Professor Zhang leads the team to make ward rounds.

Fang Xiaoyun was sitting on her bed, very calm. She trusted her doctors wholeheartedly. Her colleague was helping to massage her lower limbs. Fang Xiaoyun’s mother, Teng Guihua, was sitting on the visitor’s chair, attempting to smile at everyone, her smile a bit forced.

Everyone was still trying to adapt to her changed attitude. Did she suddenly develop a conscience? Did she feel guilty about neglecting her daughter and now wanted to make up for it?

Perhaps it was the daily objective analyses of patient conditions that have influenced them. When analyzing a condition, they wouldn’t let emotions interfere. If it’s one, it’s one; if it’s two, it’s two. Distrust in ‘one’ wouldn’t make ‘one’ change into ‘two’. Or perhaps, the extended time spent in the system space also altered their disposition.

In any case, Yang Ping didn’t quite believe that a shrew could change her ways so quickly. But he did not have to deal with her personally. All he needed to do was focus on treating Fang Xiaoyun earnestly.

Professor Zhang conducted the physical examination himself. The current muscular strength was at level two but worse compared to yesterday’s level two. She was able to move faster on her bed yesterday, but today her movements were particularly slow and weak.

The strength was decreasing progressively. Professor Zhang furrowed his brows. His decades of experience told him the situation wasn’t very promising.

“Professor, my daughter was able to walk before her surgery. But why can’t she walk now? Is she paralyzed?” Teng Guihua asked cautiously.

Professor Zhang looked at her: “We are observing closely, and we may need further examination if necessary.”

“Did the surgery fail?” Teng Guihua blurted out.