Chapter 1376: The Decision on Whether to Undergo Surgery

Chapter 1376: Chapter 1376: The Decision on Whether to Undergo Surgery

(Thanks to Yaowen for gently encouraging me about the monthly tickets)

"Teacher Liu, I’ve just admitted a patient, and I need you to handle it."

Liu Banxia was still studying when Li Hao came up to him.

"Tell me roughly what’s going on." Liu Banxia said.

"Rectal cancer chemotherapy patient, discovered rectal cancer seven years ago and underwent chemotherapy. It recurred this year, and he hasn’t defecated for four days. Ultrasound and CT results indicate some intestinal obstruction." Li Hao said.

"Is it caused by the tumor being too large?" Liu Banxia asked.

Li Hao nodded, "The patient also has congestive heart failure due to chemotherapy. He came over this time to see if you can perform surgery."

"This is really challenging. I’ll go with you to take a look first. By the way, call someone from cardiology too." Liu Banxia said.

Li Hao quickly nodded and called cardiology while leading the way.

"How old is the patient?" Liu Banxia asked.

"Sixty-three." Li Hao said.

Liu Banxia nodded, sixty-three years old. In the past, this age wasn’t considered young. But now, it can be seen as a good time.

When they reached the bedside, not only was the patient there, but his family members were present as well.

"Doctor Li has briefed me on the situation earlier. What are your thoughts?" Liu Banxia asked.

"I heard you could perform surgeries without a stoma, so I came to take a chance." The patient said with a smile.

"Do you understand your own physical condition?" Liu Banxia thought for a moment and asked.

The current situation left him a bit uncertain. In theory, this is a late stage, and attempting a TaTME surgery might be a waste of money.

The best method, and an optimal medical solution, would be to perform a stoma surgery, causing minimal harm to the patient while resolving the issue.

The patient smiled and nodded, "I know what’s going on with me. I was too careless, thought it was okay, but it relapsed. Quicker than before, it quickly reached the late stage and spread all over."

"Li Hao, put the film on, let me take a look. Is there a lab report?" Liu Banxia asked.

"Teacher Liu, it’s not from our hospital." Li Hao said.

"That’s fine, as long as it’s recent. Let’s make a rough judgment first." Liu Banxia said.

Li Hao quickly handed all the relevant materials to Liu Banxia.

Liu Banxia carefully examined them and stared at the CT film on the viewer for a while, then looked at the patient, "You are very aware of your situation, so I’ll be straightforward with you."

"Doctor, just be direct. I’ve come to this point; nothing is unbearable anymore." The patient said.

"First of all, the surgery can be performed. Although it’s more challenging than other rectal cancer surgeries, it can still be done." Liu Banxia said.

"But don’t be too quick to rejoice, because you have congestive heart failure, which brings significant risks to our surgery."

"The longer the surgery takes, the higher the risk becomes for you, and you might not make it off the operating table. This situation needs to be explained to all of you, and I also want to ask why not choose the less harmful stoma surgery?"

"The recovery time for stoma surgery isn’t very long, including the adaptation period, it’s roughly over three months. The stoma causes little harm to your body and can reduce many unnecessary risks."

"Doctor, I might as well only have half a year left, if I’m lucky." The patient said.

"You say if I lie in bed for one or two months and then spend another month or two recovering, by the time I’m recovered, I wouldn’t have many days left. Possibly not even fully recovered, and I’d be gone."

"I’ve read some information saying that the non-surgical procedures here are quicker to recover. Even if my body is a bit weak, give it half a month, and I can be well again, right?"

"For the remaining days, I could comfortably spend my last days, and visit places I want to go. If I had a fecal bag, do you think I’d dare to go far?"

"Don’t look at them. The money for the surgery is mine, and with only a few months of life left, I need to make my own decisions."

"I see that they’re not worried about the money; they’re afraid the surgery risks are too high, which you must be acutely aware of." Liu Banxia said.

"I can’t follow their thoughts. Do you think lying in bed and just breathing counts as living? What’s the point of living like that?" The patient asked with a smile.

"I’m fighting this battle so I can truly live happily for at least one month. I don’t expect more; a month is enough."

"To put it bluntly, if I can eat normally, defecate normally, and casually take a stroll, I’ll be satisfied. If I have time to stay at their houses for a few days, enjoy a few meals, I’ll consider my life fulfilled."

Listening to his words, the patient’s children started to wipe their tears.

Because everyone knows the actual condition of the patient, and no matter how hard we try, life will inevitably come to an end.

At some point, Liu Yiqing, who had come over, also began to wipe her tears. She couldn’t stand such scenes.

Liu Banxia gave a thumbs up, "The old man understands and is clear-minded, but in the current situation, I can’t give you an immediate answer. Liu Yiqing, check if Wang Lei is available, if not, call him over."

"Director Chen, you’re here just in time, please give a preliminary assessment to see how high the surgery risk factor is for TaTME, and whether the heart can withstand it."

Chen Xuehai took over to look at the examination report, and his brow furrowed.

Because his first reaction was that doing a TaTME surgery for such a patient is really too risky. If it were suggested by anyone else, he would think it’s a surgery driven by profit.

Liu Banxia is not that kind of person; he really doesn’t lack surgeries. If he wanted to operate, he could have many surgeries every day.

"The situation is not particularly optimistic," after putting down the report, Chen Xuehai said.

"His thinking is simple, he just wants to happily live out the rest of his days," Liu Banxia said.

"The recovery period for a stoma operation is long and equally dangerous to a certain extent. The TaTME curative surgery can solve the tumor on the rectum and avoid future occurrences of bowel obstruction."

Chen Xuehai paused, nodded, and understood the situation, "In principle, extended surgeries are not recommended; the tumor is also large, and even if you were to do it, it would be time-consuming."

"But for such a situation, have you called the anesthesia team? They also need to weigh in. Congestive heart failure is basically the clinical syndrome at the severe stage of heart disease."

"I have, Liu Yiqing, is Wang Lei busy?" Liu Banxia asked.

"Teacher Wang is coming over, he just stepped off the platform not long ago," Liu Yiqing said hurriedly.

Liu Banxia then looked at the patient’s children and relatives, "You also need to discuss and make a decision. Although it’s his own matter, you also have a say."

"Doctor, what is the success rate if we go ahead with the surgery?" the patient’s son asked.

"In this situation, I really can’t talk to you in terms of success rate," Liu Banxia said.

"Because his congestive heart failure is too severe, our success rates often refer to the condition of the lesion. If he can hold on, I can definitely remove the tumor from the rectum."

"Currently, we are also concerned that his heart might not withstand the surgery, so we need your input. As doctors, we tend to recommend the least invasive medical approach for the patient."

"However, his situation is somewhat special, so whether or not to take this risk has to be your decision."

That’s all he could say; the surgery isn’t particularly complex, but the risk is very high.

For the children, they need to consider whether taking the risk would allow their parent to live more comfortably. If not, it’s about just getting by.

Of course, it’s not to say that not taking risks doesn’t carry some risk, just that relatively, the risk would be smaller.

What Liu Banxia hadn’t mentioned is that even if he were to take these two surgeries, time-wise they would be similar. But this couldn’t be said out loud because you never know what unexpected situations might arise during the surgery.

At this moment, Wang Lei also came over, and Liu Yiqing quietly briefed him about the situation.

To Wang Lei, he felt at a loss because once on the platform, he would be responsible for the patient’s vital signs.

"How is it?" Liu Banxia asked.

"A difficult task, I can only say to conduct a thorough examination and give it our all. Especially concerning heart and lung function, there’s no need to elaborate as you know what the situation entails," Wang Lei said.

"OK, our opinion here is unanimous. Now it’s up to you. I think there’s no need to rush; you can take some time to think about it," Liu Banxia said.

"We can try to adjust the bowel obstruction using other methods for now, but of course, the sooner you’re ready, the better."

"Doctor, are you saying it could be done today?" the patient was a bit anxious.

"We need to complete the examination and see how the overall situation is. If the body can barely meet the standards, we could do it today," Liu Banxia said.

"After all, your bowel obstruction also needs to be addressed, and our current thinking is to try conservative treatment first, and if that doesn’t work, we’ll have to proceed immediately."

"So the difficulty level of this surgery is very high, and we need to protect the incision from contamination; your intestinal tract still contains a lot of feces."

Given the patient’s current condition, intestinal preparation is not feasible. Dragging the time longer might lead to necrosis of the bowel.

Currently, there’s no issue to speak of, so they can still consider their options.

This can be considered a small incident today; even though it’s not a trauma patient, an emergency surgery is still needed.