Top-tier doctoral supervisor, reborn as a first-year graduate student in standardized residency trai

Song Zhe also stood up from his chair, looking at Lin Hanchuan with bright eyes.

"Director, what about me?"

Lin Hanchuan glanced at him.

"Finish writing out Zhou Mingyuan's medical history for today first."

Song Zhe: "..."

He glanced at Lin Hanchuan, then at Gu Lin, and finally looked down at the thermos in his hand, where a few goji berries were floating, as if mocking him.

well.

He doesn't even have the right to be a bystander anymore.

The Thoracic Surgery MDT meeting room is in another building.

When Gu Lin followed Lin Hanchuan over, Ji Feng was already waiting inside.

The conference room was filled with people from thoracic surgery, gastrointestinal surgery, anesthesiology, radiology, and ICU.

The projection screen was lit up, displaying an enhanced CT scan.

The lesion was in a very tricky location, a huge mass at the junction of the esophagus and stomach, with the lower esophagus and cardia almost stuck together, and extending upwards close to the lower mediastinum.

The radiologist is explaining the scans.

"The lesion is about eight centimeters long, with a wide local invasion area and unclear boundaries with surrounding tissues."

"There is no clear evidence of distant metastasis at present, but the surgery will be very difficult."

Ji Feng sat in the main seat, tapping the table impatiently, his brows furrowed.

Seeing Lin Hanchuan come in, he pushed the film forward a little.

"Take a look."

"In this case, if the thoracic surgeon is responsible for the upper segment dissection and the gastrointestinal surgeon is responsible for the lower segment reconstruction, do you think it's feasible?"

Lin Hanchuan didn't speak. He sat down, switched the film back to the coronal view, and looked at a few more cross-sections.

Gu Lin stood behind him and also looked at the screen.

The film was indeed bad.

Everyone's attention is focused on the relationship between the tumor and the mediastinum.

Can it be cut? To what extent? Is it necessary to enlarge the thoracoabdominal incision?

After watching the film several times, Gu Lin's gaze slowly fell on another spot.

Upper margin of the tumor, resection margin, remaining esophageal length.

If the current estimated area to be removed is accurate...

The rest doesn't connect.

Or rather, even if it were to be forcibly connected, it would be extremely dangerous.

Ji Feng is discussing the resection approach with Lin Hanchuan.

"Our initial plan is to first perform thoracoscopic dissection of the upper esophagus, and then you can take over the abdominal cavity."

"The problem is that the patient is in poor nutritional status, and the surgery cannot be delayed for too long."

Lin Hanchuan looked at the screen, his brow furrowing slightly.

"Is a gastric tube designed in the lower part?"

"Follow the usual route."

Just as Ji Feng finished speaking, an unfamiliar voice came to his ear.

"Director, the conventional approach may not be enough."

As soon as he finished speaking, several pairs of eyes fell on him in the conference room.

Ji Feng wasn't displeased; he already had a good impression of Gu Lin.

During the previous match, he was only one point behind his beloved student. Later, he heard about Zhou Mingyuan's medical history and the emergency surgery he underwent last night.

He put down his pen and gestured for Gu Lin to continue.

Tell me about it.

Gu Lin took a step forward and switched the CT scan to the coronal view.

"To ensure the upper incision edge is clean, at least one more section of the esophagus needs to be cut."

"This means the location of the stub will be higher than expected."

"After the conventional gastric tube is pulled up, the tension will increase significantly."

"Especially for patients with poor nutrition, the risk of tissue edema is high."

He moved the image forward one layer and continued.

"In this situation, if the tension at the anastomosis site is too high, the risk of complications will be very high later."

The head of the radiology department pulled up a few more films, and his previously calm expression gradually turned serious.

"The upper edge is indeed higher than we estimated. If we cut it as you suggested, the remaining length will be very tight."

Ji Feng stared at the screen, and after a few seconds, he turned to look at Gu Lin.

"So what do you mean?"

Gu Lin's gaze remained fixed on the screen, his fingertip paused briefly at the preset path of the gastric tube, then slowly swiped down along the reconstruction direction.

He seemed to be going through every possibility again before finally withdrawing his hand and looking up at Ji Feng.

"I think the reconstruction design should be adjusted before the operation, and we can't wait until after the operation to make temporary fixes."

"The gastric tube route needs to be redesigned, and if necessary, a longer reconstruction method should be adopted; otherwise, we will be in a very passive position on the operating table."

After these words were spoken, a discussion broke out in the conference room.

Because what Gu Lin said wasn't just a small detail, but a complete overturning of the original reconstruction plan.

A deputy director of thoracic surgery next to him frowned.

"Isn't this plan too conservative?"

"The extent of resection has not yet been finalized. Changing the approach now will increase the surgery time."

Gu Lin did not immediately refute. He switched the image back to 3D reconstruction and placed his fingertip between the upper edge of the tumor and the estimated residual end.

"If we don't change it now, the surgery will only take longer if we find out during the operation that the length is insufficient."

"Moreover, the patient's condition at that time no longer allowed us to slowly redesign the treatment."

The deputy director of the thoracic surgery department remained silent for a moment.

Ji Feng leaned back in his chair, his fingers tapping lightly on the table.

His gaze darted back and forth between the film and Gu Lin, finally settling on Lin Xiuyuan, who hadn't said much to anyone beside him.

Lin Xiuyuan stood to the side, holding the medical record in his hand.

"Xiuyuan, what do you think?"

Lin Xiuyuan reviewed the coronal and 3D reconstructions.

"Teacher, if we cut it according to the original plan, the upper stump might indeed be too high, and the anastomosis tension will be relatively high after the gastric tube is lifted up."

He paused for a moment, then turned to look at Gu Lin.

"I also think that the issues Gu Lin raised need to be reassessed."

Ji Feng did not speak immediately.

The scrutinizing gazes in the conference room gradually changed.

They had only heard about yesterday's emergency surgery, but today's MDT (Multidisciplinary Team) meeting...

Gu Lin directly pointed out the most easily overlooked hidden danger in a complex combined surgery right in front of them.

This is even more remarkable than simply reacting quickly on the operating table.

Ji Feng looked at Lin Hanchuan and suddenly laughed.

"Old Lin, you've really struck gold this time."

Lin Hanchuan's expression didn't change much, but the corner of his mouth twitched slightly.

"You only found out now?"

The head of the oncology department suddenly interjected.

"But I heard that Gu Lin is Old Zhou's student."

Lin Hanchuan: "..."

Seeing Lin Hanchuan's embarrassed expression, someone in the conference room chuckled softly.

The tense atmosphere finally eased a little.

But soon, Ji Feng brought the topic back to the cases.

"The plan needs to be redone. The reconstruction path will be redesigned in the gastrointestinal surgery department, and the thoracic surgery department will adjust the dissection range accordingly."

He put the pen on the medical record and looked up at Gu Lin.

"Gu Lin, you and Director Lin should work together to draft a version of this reconstruction plan. We'll have another small meeting this afternoon."

"it is good."

Lin Xiuyuan looked at Gu Lin, his mouth moved, but in the end he didn't say anything.

While others were debating whether the tumor could be removed, Gu Lin saw another danger after it was removed.

However, like everyone else, he fell into the misconception of "how to cut".