Famous Among Top Surgeons in the 90s-Chapter 1907: To Preserve or Not
Du Haiwei turned to look at the other doctors.
The other doctors present nodded in agreement with Student Xie’s insights.
In this case, there was no need to wait for the colonoscopy results; rather, they should proceed with the pre-surgical discussion, so that as soon as the colonoscopy is completed, the surgery can take place immediately. What everyone needs to discuss now is the surgical procedure for the patient.
"The patient is older and has one child, so there shouldn’t be a strong desire to preserve fertility; we can proceed with a full hysterectomy," Zuo Liang first proposed a tentative surgical plan for everyone to discuss.
A full hysterectomy for cervical cancer refers to a radical uterus removal surgery, which involves removing the uterus and the adnexa, along with a pelvic lymphadenectomy and a para-aortic lymph node sampling. This essentially discards all of the patient’s fertility, the harm to female patients is unimaginable. 𝕗𝐫𝚎𝗲𝘄𝐞𝕓𝐧𝕠𝘃𝕖𝐥.𝐜𝚘𝚖
Clinical doctors consider whether a full hysterectomy is appropriate, as Dr. Zuo Liang mentioned, it’s not just based on staging but whether the patient needs to preserve fertility. It’s worth noting that surgeons within the country tend to be more cautious than those abroad.
Many foreign surgical research papers suggest that early-stage cancer does not require a full hysterectomy and will not impact the patient’s survival; the pathological stage is more crucial, and surgery can attempt to preserve organs. Breast and uterus-preserving surgeries hold tremendous significance for female patients with breast and cervical cancer, so if asked, patients would lean toward preservation whenever possible.
After this advanced surgical philosophy was introduced domestically, most doctors, aside from using it to promote themselves, actually don’t prefer performing such conservative surgeries. Only a small number of top-tier hospitals and elite doctors are willing to take the risk. The main reason is that organ-preserving surgeries demand higher surgical skills and require a pathology department capable of integrating with precise surgical procedures.
Just consider that even a full hysterectomy might quickly lead to a recurrence. A breast and uterus-preserving surgery might lead to a faster recurrence, at which point it might be too late to regret not having done the full hysterectomy. Domestic doctors are very wary of patients and their families causing trouble post-operation. The public only knows that for malignant tumors, to survive, the cancer cells must be thoroughly excised. If a patient experiences a quick recurrence after surgery, they will claim the surgery was inadequate. Some patients and their families criticize full hysterectomy, claiming the doctor didn’t excise enough, let alone partial excision.
The surgical plan proposed by Dr. Zuo Liang didn’t seem to face any opposition from the doctors. Especially as everyone knew this patient was someone likely to cause trouble, avoiding future complications by excising as much as possible was the prudent choice.
"What do you think?" Du Haiwei asked Student Geng.
Geng Yongzhe seemed to be contemplating, his pen tapping on his notebook.
The others were a bit puzzled by his hesitation at this moment.
"Give your opinion," seeing him silent, Zuo Liang prompted Student Xie to speak up to save time.
"I think this patient is quite attentive to her physical health and sought treatment in the Capital immediately upon learning of her condition, indicating a desire to preserve her uterus," said Xie Wanying. "Her current stage is tentatively IA, so a cervical conization can be attempted. If the pathological results are unfavorable, showing it might be at stage IB requiring expanded surgery, a radical cervical excision with pelvic lymphadenectomy and para-aortic lymph node sampling can be performed."
Student Xie focused solely on the technical aspects of what she said, with no concern for whether the patient’s family would cause trouble.
