Surgery Godfather
Chapter 1078 - 882: The Lost Pathology Report

Chapter 1078: Chapter 882: The Lost Pathology Report

Director Fang’s enthusiasm is incredibly high now because he is an ambitious person, not your average man. He has set his professional target to become a world-class general surgery expert.

He is still very far from this target, but Director Fang thinks—what if he actually achieves it?

So, starting from now, Director Fang demands of himself to strive toward this target. Of course, Director Fang hasn’t told anyone about his dream, wanting to achieve it quietly. Every time he thinks about his ideal, Director Fang feels his blood boiling with excitement.

At the moment, Director Fang encounters a patient in the outpatient department—Nong Tiesheng, male, fifty-seven years old, post-operative complications from thyroid cancer, including recurrent laryngeal nerve injury. The patient now presents with obvious dysphonia and easily chokes while drinking water. Ordinary eating also leads to frequent coughing and even affects his breathing.

Director Fang concludes from the medical records brought by the patient that the tumor had invaded the recurrent laryngeal nerve and its surroundings, so surgery had involved a segmental resection of the nerve to completely remove the tumor.

However, an injury to just one side of the recurrent laryngeal nerve should not cause such severe symptoms. The patient’s feeling of breathlessness suggests that the other nerve is also damaged, just not severed, perhaps due to contusions during surgery, or post-operative scar compression.

If treatment is to be sought, surgery is necessary—the damaged side of the recurrent laryngeal nerve must be repaired and the other side explored.

This surgery is actually nothing special, just a routine operation. Repairing the recurrent laryngeal nerve typically involves bridging the injured nerves or taking another nerve from a different area to replace and perform the original nerve’s function.

The patient has already undergone several surgeries, adding a certain level of difficulty. Director Fang decides it would be better to discuss the case with Yang Ping. The current Director Fang has different expectations for himself and a completely different perspective than before; he wants to achieve a high standard in every surgery, even attempting to innovate and improve the procedures.

Director Fang, with the patient in tow, comes to the Surgical Research Institute to find Yang Ping to study the illness together.

Yang Ping flips through the patient’s thick stack of medical records. The patient has already undergone surgery twice, and the scope of the surgeries was fairly extensive.

The recurrent laryngeal nerve controls the vocal cords, with one on each side. Unilateral damage causes hoarseness and choking when drinking water, while bilateral damage can result in speech, eating difficulties, and respiratory distress.

Protecting the recurrent laryngeal nerve is an important aspect of thyroid cancer surgery. The chief surgeon must be extremely careful to preserve it and avoid any injury.

However, in some patients where the tumor has seriously invaded the trachea and recurrent laryngeal nerve, in order to remove the tumor completely, it becomes necessary to perform a segmental resection of the parts invaded by the tumor. This is referred to as segmental resection of the recurrent laryngeal nerve.

Because of the physiological importance of the recurrent laryngeal nerve, it cannot be left unattended after resection. Otherwise, the patient may, at the very least, suffer from hoarseness and choking when drinking water, or, at worst, severe impacts on breathing, eating, and speaking.

If a segmental resection of the recurrent laryngeal nerve has already been performed, post-operative nerve repair is required. Traditional repair methods come in three types: the simplest is direct end-to-end anastomosis; however, if the resected segment is too long to be directly approximated, another nerve must be taken to bridge the ends of the severed recurrent laryngeal nerve, similar to coronary artery bypass—except here, nerves are bridged instead of blood vessels. If the bridging span is too great, it can result in poor recovery; in such cases, the phrenic nerve or the ansa hypoglossi can be cut and anastomosed with the ends of the recurrent laryngeal nerve, using another nerve to replace its function.

The patient brought a lot of medical records, and Yang Ping turned the pages slowly, finding that nearly all examinations had been done, including in the records, except for the pathology report—perhaps the patient had forgotten it.

"Why isn’t there a pathology report?" Yang Ping handed the medical records back to Director Fang.

Director Fang also flips through the records again and indeed can’t find the pathology report. Initially, he had only glanced through them casually and hadn’t paid much attention to this detail, focusing instead on the discharge summary.

"Which doctor at Affiliated Hospital No. 4 performed your surgery?" Director Fang asks the patient’s son, Nong Zhiwen.

Nandu Medical University Affiliated Fourth Hospital, among the several affiliated hospitals of Nandu Medical University, was relatively late in its establishment and not particularly well-known. In terms of strength and reputation, it didn’t compare to Affiliated Hospital No. 1 or No. 2, or the Affiliated Cancer Hospital.

But Affiliated Hospital No. 4 was still an affiliated hospital of Nandu Medical University, a teaching hospital, and wouldn’t be poor by any means. It was still considered one of the secondary powerhouses in Nandu Province.

"Director Qian!" Nong Zhiwen replied.

"Qian Lisheng?" Director Fang was very familiar with this Director Qian.

"Yes, it’s Director Qian Lisheng," Nong Zhiwen confirmed.

If he had known earlier that it was Qian Lisheng’s patient, Director Fang wouldn’t have touched the case.

Because Director Qian has an infamous reputation in the field, known for his poor skill level. Of course, this is only known within the circle; the general public has no idea, and everyone thinks he’s highly skilled because he holds many titles as a senior expert and professor.

Almost none of the surgeries Director Qian performs go smoothly. As long as other doctors are aware, they dare not take on his patients. He has a notably high rate of injuring the recurrent laryngeal nerve during thyroid cancer surgeries, and not just with this surgery; he’s sloppy with every operation, few of which turn out well, but this doesn’t stop him from continuing to be a senior professor.