My Medical Skills Give Me Experience Points Chapter 1402 - 557: Destruction Isn’t the Same as Harm—An Anesthesiologist Who Brings Ease (2)

Tan Shengli inquired about the cause of the patient’s esophageal fistula from Zhou Can, appearing to set aside his own notions and ready to fully absorb Zhou Can's perspective.

"As widely known, spontaneous esophageal rupture, if not addressed surgically with haste, leads to a swift demise due to severe infection, malnutrition, and systemic failure. However, post-esophageal repair surgery, recurrences of rupture are common, typically appearing three to seven days after the operation. Should this secondary rupture be minor, enhancing nutrition, ensuring clear drainage, judicious antibiotic use, and maintaining gastrointestinal decompression can facilitate spontaneous healing if managed correctly."

Zhou Can presented a comprehensive plan for patient recovery.

His core reasoning was straightforward: since further esophageal repair surgery was not viable, allowing the fistula to mend on its own was the path forward.

This could be fully achieved by ensuring adequate nutrition and maintaining stringent control over infection.

The primary drawback would simply be a potentially longer treatment duration.

"Dr. Zhou's proposed recovery measures are indeed excellent. But with the patient's esophagus currently experiencing a fistula, ingested food will inevitably leak into the chest cavity. How then can we ensure sufficient nutrition?" Tan Shengli pondered, believing this crucial point remained unresolved, rendering the entire plan theoretical.

"It's simple; performing a jejunostomy on the patient will resolve this issue," Zhou Can responded with unwavering confidence.

"Jejunostomy?" Director Tan's eyes widened in surprise, mirroring the astonishment evident on everyone else's faces.

An existing esophageal fistula was already a grave complication; the idea of intentionally creating another opening on the jejunum was, to them, a remarkably bold and perhaps even reckless strategy.

An inherently conservative physician like Tan Shengli would never have conceived of such a solution.

In his estimation, the concept was simply too extreme.

Any surgical intervention inherently carried risks for the patient; enduring a postoperative esophageal fistula was misfortune enough, and now to consider cutting into the jejunum seemed like compounding the suffering.

"Precisely, a jejunostomy. While creating a fistula on the jejunum does present some risks to the patient's body, the resulting benefits significantly outweigh the drawbacks. Firstly, post-jejunostomy, food can be directly introduced into the digestive system, bypassing the esophagus entirely. This minimizes ongoing infection and prevents further enlargement of the esophageal fistula, thereby establishing the necessary conditions for its gradual healing."

Wounds are vulnerable to moisture and infection.

For survival, the patient must consume sustenance and fluids daily, inevitably leading to persistent infection and potential suppuration of the esophageal fistula.

While antibiotics can manage infections, they are not a cure-all.

The most effective treatment strategy is always prevention.

Preventing infection is far more effective than combating it after it has occurred.

The former ensures the wound remains uncompromised, while the latter involves addressing problems only after they manifest.

This logic aligns with the principle of superior physicians addressing potential ailments before they arise, whereas inferior physicians only intervene once illness has taken hold.

The distinction between these approaches is starkly evident.

Zhou Can’s surgical mindset already displays the early characteristics of a superior physician, while Director Tan, if he fails to adapt his thinking, risks remaining an inferior physician throughout his career.

"Secondly, administering various nutrients directly to the patient via the jejunal fistula guarantees an adequate supply of nourishment. With sufficient nutrition, the patient's innate healing capacity and immune response will be substantially bolstered. You can observe that the patient's current condition is severely compromised due to malnutrition, with clear signs of systemic exhaustion."

The patient's complexion was alarmingly poor; despite stable vital signs, they were enduring a persistent high fever.

In this state, the individual's overall condition was exceptionally grave.

For an average person, a severe cold accompanied by fever and a runny nose can feel debilitating. This patient, having just undergone major surgery, suffering such a condition is truly piling misfortune upon misfortune.

Without prompt intervention, the patient's life would soon be forfeit.

Recognizing the severe danger, the doctors and leadership at First Hospital had urgently sought assistance from external medical experts.

"Dr. Zhou's proposed surgical approach is highly scientific and logical. I believe it offers a significantly superior path compared to our previous consideration of secondary repair via thoracoscopic surgery. It presents substantial benefits for both postoperative recovery and long-term quality of life. While it may appear to inflict secondary harm upon the patient’s body, it is, in fact, a crucial intervention—akin to scraping the bones to eliminate poison—creating the optimal conditions for complete healing."

Director Hei, the head of anesthesiology, endorsed Zhou Can’s innovative surgical approach at this juncture. His backing significantly boosted the plan's feasibility. Without an anesthesiologist's approval, no surgical procedure can commence. If she deemed the surgery viable, then it was indeed viable. Conversely, if she opposed it, even the most meticulously crafted surgical plan by the chief surgeon would be shelved. Such disagreements often led to heated, red-faced debates in their offices, though these were typically short-lived. Like marital spats, they would quickly reconcile, alleviating any lingering concerns. Ultimately, everyone's focus was on the task at hand, and personal grudges were not fostered at this professional level.

"Dr. Zhou's proposed method appears… radical, but upon careful reflection, I too believe this treatment strategy offers greater safety and superior outcomes," Tan Shengli stated, stopping short of fully endorsing Zhou Can for the lead surgeon role. Granting Zhou Can the lead position meant ceding decision-making authority entirely to him. If they were to retain control over crucial decisions, Zhou Can would merely be an assistant, not the lead surgeon.

"Given Director Hei's endorsement of Dr. Zhou's surgical plan, let us proceed without delay! We pledge our full support and cooperation for any necessary resources."

Song Qian's professional standing remained somewhat ambiguous, as she had not introduced her specific role. Even Jiang Wei had not disclosed her classmate's current position at the First Hospital. However, intuition suggested her status was substantial. Her calm demeanor while addressing established physicians like Director Tan and Director Hei indicated a position of influence. Furthermore, her decisive interventions in various matters, acting with the finality of a high-ranking executive, pointed towards a significant role.

"I have no further requirements beyond needing my colleague to assist as a medical aide and Jiang Wei to serve as the instrument nurse." Zhou Can's sole request was to have his trusted personnel by his side during the operation.

"Absolutely achievable."

Song Qian subtly signaled for the designated instrument nurse and the original medical aide to step aside. The operation commenced shortly thereafter.

Zhou Can proceeded to offer the First Hospital staff a profound demonstration of surgical mastery. The entire procedure was concluded in under forty minutes. Upon its successful completion, he was awarded 1000 pathologic diagnostic experience points. This reward was likely linked to his proposal of a novel surgical strategy – not entirely unprecedented, but possessing a unique flair and demonstrating the skillful application of diverse surgical and medical knowledge. Such practical expertise could not be solely acquired from textbooks, which typically conveyed foundational knowledge and theories. Translating that knowledge into effective diagnosis and treatment demanded continuous practical application and experience accumulation.

Following the surgery, Zhou Can conducted a thorough post-operative examination of the patient to confirm the absence of any complications. Only then did he remove his gloves and discard them.

"All done. Transfer the patient to the recovery room for anesthesia reversal. Observe for approximately thirty minutes; if no anomalies arise, they can be moved back to the ward for ongoing care. We can commence feeding via the jejunal fistula tomorrow, ideally managed by a seasoned nurse. The patient's hospital stay is projected to be lengthy, with the esophageal fistula potentially requiring at least a month to heal," Zhou Can informed Tan Shengli and Song Qian.

"Understood. I will arrange for my team to depart now."

"Allow me to escort you out. Your efforts today were truly commendable." Song Qian expressed her satisfaction with the successful surgery. As Zhou Can prepared to leave, he turned to Director Hei, the anesthesiologist.

"It was a pleasure working with you; your intraoperative management was exceptionally proficient. Among all the anesthesiologists I've collaborated with, this was the most seamless surgical experience." Zhou Can intentionally phrased it as the most relaxing *surgery*, not the most relaxing *anesthesiologist*.

"Thank you for the compliment!" She responded with a modest smile, the first Zhou Can had witnessed from her.

"Farewell!" He, Jiang Wei, and Zhong Ming exited the room. Director Hei's skills as an anesthesiologist were indeed outstanding – professional, meticulous, and in perfect sync with the lead surgeon. She even anticipated Zhou Can's next moves, providing the necessary life support or preparatory actions. Throughout the entire surgical process, Zhou Can felt an effortless flow, a stark contrast to his experiences even with Director Feng at Tuya Hospital, who had never made him feel quite so at ease during an operation.