Chapter 37 Changes in Surgical Plans
In the cafeteria of Eastern University Affiliated Hospital, Chen Yu was discussing with Daimon Michiko about Inomata Naoki’s surgery.
"Daimon-san, because you are banned from practicing medicine in Japan, you will only be observing the surgery this time, acting as the third assistant," Chen Yu explained to Daimon Michiko, which was the solution he and Professor Kube had come up with: "After all, it was the Japan Medical Association that banned you from practicing in Japan, and even Professor Kube cannot overturn this ban.
We can only let you perform surgery this way. Please forgive us."
Faced with Chen Yu’s explanation, Daimon Michiko appeared quite indifferent. She waved her hand carelessly and said, "Anything is fine, as long as I get to perform surgery. I haven’t operated for so many days since returning to Japan; I’m almost suffering from withdrawal symptoms!"
As she said this, Daimon Michiko was wringing her hands, looking somewhat restless.
"Is surgery your passion?" Chen Yu asked with some surprise, for he had never seen someone exhibit withdrawal symptoms from not being able to perform surgery. At that moment, Daimon Michiko looked just like an otaku who hadn’t played video games or watched anime for a week.
"Aside from that, I have some new ideas about the surgical technique," Daimon Michiko said, picking up Inomata Naoki’s X-ray that Chen Yu had put aside and looking at it against the light source: "The subtotal esophagectomy remains unchanged, but the reconstruction using the posterior mediastinum method involves stretching the patient’s stomach for esophageal reconstruction.
This approach will cause the patient’s stomach to shrink, leading to postoperative problems such as reduced appetite and weight loss."
"That’s correct, but this is an inevitable consequence of the surgery. Compared to staying alive, a few postoperative sequelae are not a big problem," Chen Yu certainly knew the sequelae that the surgery could cause, but this was an unavoidable issue; the sequelae were inevitable with this kind of surgical approach.
After all, to completely remove the tumors grown near Inomata Naoki’s esophagus, his affected part of the esophagus had to be entirely removed. Esophageal reconstruction through stretching the stomach would inevitably lead to a reduction in stomach size, and the resulting sequelae were considered mild.
"You say that, but such sequelae can affect a patient’s life," Daimon Michiko did not overlook the issue just because the sequelae weren’t severe. She proposed a new surgical plan to Chen Yu: "So, I plan to use the colon to reconstruct his esophagus instead of stretching the stomach, preserving the function of the stomach and minimizing postoperative sequelae."
Hearing Daimon Michiko’s suggestion, Chen Yu furrowed his brow while considering the consequences of changing the surgical plan. As a surgeon and a doctoral graduate of the University of Tokyo Medical School, Chen Yu naturally understood the benefits of what Daimon Michiko planned to do. However, he was also aware of the increase in surgery difficulty that would entail.
"Using the colon? But wouldn’t that make the surgery too difficult? First, the tumor and esophagus have to be removed, then a segment of the colon taken from the abdomen, and the severed intestinal tract sewn back together. Finally, the colon is used for esophageal reconstruction. That’s two more steps than the original surgical approach, greatly increasing both the difficulty and risk of the surgery.
Are you confident you can complete it?" After carefully considering the pros and cons of the surgical plan, Chen Yu asked Daimon Michiko.
"Of course, if I can propose such a surgical plan, naturally I can complete it. Because I will not fail," Daimon Michiko said with confidence, repeating her favorite catchphrase with a smile.
Once again feeling the aura that Daimon Michiko exuded, and sensing the resonance with the Power of Faith in her when she said "I will not fail," Chen Yu thought for a while. Ultimately, he nodded and agreed to her surgical plan.
"Well, since you say so, Daimon-san, I’ve decided to trust you," Chen Yu said, no longer dwelling on the matter, and turned to Daimon Michiko. "During the surgery, I’ll first complete the removal of the tumor and the esophagus. As for the reconstruction of the esophagus, I’ll leave that part to you, Dr. Daimon. I hope the surgery goes smoothly."
After speaking, Chen Yu reached out his hand toward Daimon Michiko, hoping to shake hands with her as a way of wishing for a successful surgery.
Looking at Chen Yu’s hand extended in front of her, Daimon Michiko paused for a moment, then looked at Chen Yu before hesitantly reaching out to shake his hand, "Since it’s settled, I’ll be leaving now. Remember the promise you made if the surgery is successful."
"Don’t worry, I won’t forget," Chen Yu said with a smile upon hearing Daimon Michiko mention his promise.
Watching Daimon Michiko confidently leave the restaurant, Chen Yu then proceeded to pack up Inomata Naoki’s medical records from the table and prepared to return to his office.
Just as Chen Yu was packing up, Dr. Higashiyama, who appeared to have finished his business, suddenly sat down in front of him and addressed him, "Doctor Chen, were you just discussing the surgical plan for your patient?"
"Yes, that’s right. Any problems?" Chen Yu looked up at Dr. Higashiyama and, recalling that his patient also suffered from esophageal cancer, asked with some understanding, "Your patient has esophageal cancer, doesn’t he, Doctor Higashiyama? Are you interested in my surgical plan?"
Dr. Higashiyama nodded eagerly and explained to Chen Yu, "My patient is named Hanayama Mikie, a popular online celebrity chef. She has the same esophageal cancer as your patient. My original surgical plan was to remove the esophagus and reconstruct it by stretching the stomach, similar to what you described earlier. But..."
"However, if the patient is a chef, obviously she won’t accept a solution that could impact her future career," Chen Yu said, immediately understanding Dr. Higashiyama’s purpose, "After all, stretching the stomach could lead to complications like recurrent laryngeal nerve paralysis causing voice abnormalities, difficulties in chewing and swallowing, and even an impact on taste.
For a chef, these could ruin her career."
"Exactly, so when I overheard you discussing an alternative surgical technique that doesn’t require stretching the stomach for esophageal reconstruction, I wanted to ask you about it..." Dr. Higashiyama seemed a bit embarrassed, as eavesdropping is very impolite, but he pleaded with Chen Yu, "Doctor Chen, this matter affects Miss Hanayama’s future, so I must ask... please, I urge you to help me!"
With that, Dr. Higashiyama stood up from his seat and bowed deeply to Chen Yu.
"But my surgical technique entails using the colon for esophagus reconstruction, and it’s a very difficult surgery. I only had the confidence to perform it with help from a friend," Chen Yu felt somewhat perplexed, aware that the technique was shared by Daimon Michiko, who was confident in its success.
"Even if I share the technique with you, Doctor Higashiyama, are you confident that you can carry it out?"
"Ah?" Dr. Higashiyama was taken aback.