Chinese medicine: from rural hospitals to top three hospitals in Kyoto

On the first day of observation of the operation, the news that Chen Yang made the final decision and helped Ishii Ryosuke complete the correction of the difficult congenital heart disease spread like wildfire to every corner of Tokyo's top medical circle, causing quite a stir.

The attitudes of some experts from Country R, ​​who were originally just watching the show and even wanted to give the Chinese delegation a warning, quietly changed.

The inherent contempt and arrogance were restrained a lot, replaced by a cautious attention and an uncontrollable curiosity - who exactly is this Chen Yang?

After all, Ryosuke Ishii holds a high position in the field of cardiothoracic surgery in Country R.

The second operation was in the field of hepatobiliary surgery and was performed by another senior professor at Juntendo Hospital who was known for his steadiness.

Perhaps because of Ishii's previous experience, the professor acted extremely cautiously and steadily. The entire operation was textbook-level, smooth and flowing, with almost no flaws left. Naturally, he did not give Chen Yang too many opportunities to "give advice."

But at the subsequent case discussion meeting, Party R was obviously well prepared and once again brought up an extremely difficult case - a patient with advanced cirrhosis and liver cancer, and extensive cancer thrombosis in the main trunk and left and right branches of the portal vein. The patient's condition was hopeless.

"For advanced cases like this, surgical resection carries an extremely high risk, almost guaranteeing death, and the prognosis is extremely poor. We generally prefer palliative treatments such as transarterial chemoembolization (TACE) combined with targeted drugs."

When the R expert introduced the patient's condition, there was a hint of "this road is blocked" in his tone, and his eyes vaguely swept over the Chinese delegation, especially in the direction of Chen Yang.

The atmosphere in the conference room suddenly became subtle, and everyone's eyes were once again uncontrollably focused on Chen Yang, waiting for his response.

Chen Yang's face remained calm as he carefully flipped through the imaging materials in his hands, his eyes sharp as an eagle, not missing a single detail. After a moment's hesitation, he raised his head, met the man's gaze, and spoke in a calm tone with undeniable strength: "The cancer thrombus is indeed extensive and invasive, but in my opinion, surgical cure is not completely impossible."

"Oh?" The professor from Country R who presented the case raised an eyebrow, a subtle hint of surprise and questioning crossing his face. "Professor Chen, what are your thoughts? I'd love to hear more."

"It's not a brilliant idea." Chen Yang's tone remained calm, but with a confidence that he was in control of the overall situation.

"The key lies in accurate pathological classification of portal vein tumor thrombus and optimal selection of surgical approach. Based on imaging findings, although the tumor thrombus is extensive, its main portion is located in the right branch of the portal vein, with a slight gap remaining at the beginning of the left branch. Furthermore, the tumor thrombus has not completely invaded or infiltrated the entire thickness of the portal vein wall."

Chen Yang stood up, walked to the projection screen, picked up the inductive pen, and began to outline the complex image clearly and accurately. "We can consider 'combined portal vein main trunk and right branch cancer thrombus removal, left hemihepatectomy, and portal vein plasty.'"

"The core difficulty of this operation lies in how to completely and thoroughly remove the cancer thrombus without leaving any residue, while ensuring the patency of the main portal vein blood flow and the integrity of the remaining left hepatic portal vein branches."

Then, in his unique, clear and logical style, Chen Yang elaborated on the steps, key points, and risk management of the entire operation: from how to fully free the liver to how to precisely block blood flow; from choosing the optimal site for portal vein incision to using specialized instruments and ingenious techniques for thrombus removal; to how to determine whether the cancer thrombus has been completely removed during the operation, and the techniques and precautions for meticulously suturing the portal vein incision...

Chen Yang's explanation was meticulous and logical, breaking down an operation that seemed like a fantasy and impossible to complete to others into clear, feasible and interlocking operating steps.

In particular, the points pointed out about several easily overlooked cancer thrombus attachment points and potential fatal bleeding risk points made all the hepatobiliary surgery experts present listen attentively and fascinated. Some of them even couldn't help but take out their notebooks and quickly record them for fear of missing a word.

"...Of course, I must emphasize that this type of surgery requires extremely high skills of the surgeon, tacit cooperation of the team, and meticulous postoperative management, and requires extremely rich experience support. However, under the premise of strictly screening suitable cases, striving for the opportunity of radical resection is of great significance to the patient's long-term survival, far beyond the reach of palliative care." Chen Yang finally concluded in a steady and powerful voice.

As soon as Chen Yang finished speaking, there was a brief silence in the conference room, so quiet that you could hear a pin drop. Then, a discussion even more heated and excited than before rang out.

"It turns out... we can perform surgery from this angle!"

"The selection of the site for portal vein incision is crucial. Professor Chen pointed out this point, which we often overlooked before. No wonder the success rate is so low!"

"It's completely feasible in theory, the idea is so clear! But in practice... the risks are immense, and it requires absolute confidence in anatomy and one's own skills!"

The doubt and challenge on the face of the professor from Country R who presented the case had long since disappeared without a trace, replaced by an extremely solemn and thoughtful expression.

He had to admit that although the surgical plan proposed by Chen Yang was extremely bold, it was by no means whimsical. The technical ideas and profound insights into the anatomy of the liver portal contained therein gave him great shock and inspiration.

"Thank you for your advice, Professor Chen." The other party finally nodded to Chen Yang with full conviction and a sincere tone. This nod represented the recognition of Chen Yang's strength in the field of hepatobiliary surgery in Country R.

For two consecutive days, whether it was on-the-spot guidance in the operating room, turning the tide, or theoretical confrontation and unique insights at the conference table, Chen Yang demonstrated his overwhelming absolute strength and master style.

Chen Yang is not only proficient in technical details, but also has a broad global vision. He can always get straight to the point about the essence of the problem and propose refreshing yet reasonable and highly feasible solutions.

The morale of the Chinese delegation members was greatly boosted. Walking in the corridor of Juntendo Hospital, they felt their backs straightened and their faces were filled with pride.

Wen Haodong even wanted to write the word "awesome" directly on his face, and the look he gave his counterparts from Country R was full of pride.

However, the R country, especially the top authorities who have not yet taken action, are feeling increasing pressure.

Chen Yang was like a towering mountain that suddenly rose from the ground without any warning, calmly and domineeringly blocking their habitual downward gaze, making them feel suffocated and uneasy.

Chen Yang brought his team to Tokyo to give orders, as if to show the outside world that China's level in various fields is higher than that of Country R. This made the experts and people of Country R, ​​who have always been ahead of China in many fields, feel complicated for a while.