Chapter 293 Solitary kidney

In order to perform urological surgery well, Su Jie learned a lot of relevant knowledge about urological surgery during this period.

Solitary kidney is an interesting extracurricular knowledge supplement. At least when he saw this disease at that time, Su Jie never thought that he would encounter it clinically.

Or even if we meet, it won't be so soon.

This is a rare congenital developmental disorder.

The kidneys of normal people grow in pairs and are buried in shallow fossae on both sides of the retroperitoneal spine.

However, some people have one kidney missing as early as the embryonic stage due to underdevelopment, leaving only an isolated kidney buried in the lower back.

Director Dou said at this time: "The patient's name is Xu Lingdong. He is thirty-five years old this year. He was diagnosed with solitary kidney, kidney stones, and infection."

"Because the solitary kidney has lost the compensation of the unaffected kidney, the possibility of stones and obstruction is greater than that of ordinary people, and once obstruction occurs, the risk of infection is also higher."

"I saw the CT scan he took last week. The condition of his kidney stones is not very good. Surgery must be scheduled quickly."

After listening to Director Dou's introduction, Su Jie suddenly understood why this patient was so difficult to communicate as soon as he entered the hospital.

He only has one kidney. If there is another problem with this kidney, he will have no kidney to use.

When a person has a retreat and a second choice, he can often remain calm enough and stick to the idea of ​​"if this plan fails, there is another plan."

But what if a person has no way out and if he takes another step back, he will reach a cliff?

This patient named Xu Lingdong was born without one kidney, and only the other kidney was struggling to shoulder double responsibilities.

And now, the kidney on this side is also beginning to be in danger.

The kidneys are responsible for producing urine and removing toxins from the body. Once both kidneys are necrotic and missing, the patient has only two options.

First: lifelong hemodialysis treatment, three times a week, four hours each time, the blood from the whole body is pulled out, filtered three or four times, and then reinfused into the body.

Second: Kidney transplant, inserting someone else's kidney into your own body, but you still have to use rejection drugs for life.

Xu Lingdong is only 35 years old this year. If he loses both kidneys at this age, you can imagine how difficult the rest of his life will be.

Having no way out was the fundamental reason why it was difficult for him to speak.

He wants to keep his destiny firmly in his own hands.

But Su Jie couldn't help but think that destiny is like running water. The more tightly you hold it, the easier it is to flow away from your fingers...

Director Dou and Yamashita Oda both knew the patient's condition, so although they were a little dissatisfied with the patient's attitude, they could understand it.

"Dr. Yamashita, can you perform the percutaneous nephroscopic surgery on this patient?"

Director Dou could no longer remember how many times he had asked Yamashita Oda similar questions, but Yamashita Oda would refuse the surgeon every time because the surgery was not suitable.

The so-called inappropriateness can also be understood as too simple, and Yamashita Oda can't stand it.

But this time, Yamashita Oda seemed to be tempted.

"Cases of solitary kidney are very rare. I can perform the surgery." Yamashita Oda nodded and agreed.

"Okay." Director Dou said with a smile.

Yamashita Oda is an expert doctor trained by Japan's elite education system. Compared with Chinese doctors, he actually lacks some down-to-earth temperament.

This can be seen from the fact that he always wears white shirts and has a proud posture, without even looking at the patient.

In Yamashita Oda's eyes, when a patient comes to seek medical treatment, he means to seek medical advice.

The reason why he agreed to Xu Lingdong's percutaneous nephroscopic surgery was certainly not because he felt sympathy when he saw Xu Lingdong's critical condition.

He was totally attracted to this special case.

For a surgeon, one operation on a special case can bring him more inspiration and progress than a hundred routine operations.

Solitary kidneys are not common even at Tokyo University Hospital. Yamashita Oda just didn't want to miss such a precious opportunity to perform surgery.

After picking up Xu Lingdong's medical records and studying them, Yamashita Oda said in a deep voice after a long time: "It's very complicated and very challenging."

Director Dou specially called Su Jie because he hoped that he could participate in this operation and accumulate more experience. It would be better if he could learn the essence from Yamashita Oda's operation.

Therefore, in order for Su Jie to better understand this operation, he explained in a low voice at this time: "The solitary kidney has lost the compensation of the other kidney, and the blood flow is greater. During percutaneous renal puncture, the risk of bleeding is greater.

."

"And considering that the patient currently has only one working kidney, the surgical trauma should not be too great, otherwise the recovery time will be too long and the kidney function will not be restored, which will also cause a vicious cycle."

Su Jie nodded, and the two current difficulties of this operation clearly emerged in his mind:

Bleeding control, and minimally invasive surgery.

"Bleeding is always an unavoidable problem in percutaneous nephroscopic surgery. The risk can only be reduced through the surgeon's superb puncture technique. There is no other way."

Now that he is in a field he is familiar with, Yamashita Oda seems to be somewhat more fluent in Chinese: "But I have other ideas about minimally invasive techniques."

"No control?" Director Dou predicted in advance.

Yamashita Oda originally wanted to let it go, but he didn't expect Director Dou to reveal the mystery directly, which made him mutter with some dissatisfaction: "Yes, no control."

Seeing Su Jie's puzzled expression, Director Dou explained: "In conventional percutaneous nephroscopic surgery, a nephrostomy tube will be left in the puncture channel after surgery to drain urine, compress and stop bleeding, and provide a secondary surgical channel. At the same time,

, the surgeon will also place a double J tube in the patient’s urethra to prevent secondary obstruction by stones.”

"But this will undoubtedly create a potential risk of secondary trauma to the patient."

"There is a possibility of massive bleeding when the fistula tube is extubated, and the double J tube itself also has the risk of causing obstruction."

"The Affiliated Hospital of Dongda University has now developed an advanced percutaneous nephroscopic surgery method, which is to completely remove the stones through a one-time operation, ensuring that various complications will not occur, without leaving a fistula tube, and a double J tube

, complete the operation in one go.”

"This is the tubeless version of percutaneous nephroscopy, and it is also the specialty of the Department of Urology, Dongda Affiliated Hospital."

Su Jie said thoughtfully in a low voice: "Tubeless is equivalent to the lithotripsy surgery for antler-shaped stones in the Department of Urology of Southeast Hospital?"

"That's right." Director Dou said with a smile.

In other words, Yamashita Oda came here for lithotripsy surgery for staghorn-shaped stones in the Department of Urology of Southeast Hospital, but before he could learn this technique, he had to contribute his special skills first?

Su Jie suddenly felt sorry for Yamashita Oda. This international friend didn't seem to be having a good time at Southeast Hospital...

Yamashita Oda seemed to have seen through Su Jie's thoughts, and smiled without caring at all and said: "Will the patient accept tubeless surgery?"

"Huh?" Su Jie and Director Dou were both stunned, not understanding what Yamashita Oda meant.
Chapter completed!