Chapter 709: Listening makes one’s eyes light up. Chapter 709: Listening makes one’s eyes light up. “The two of them are being deferential to each other,” from among the assistants, He Guangyou was the first to speak up quickly, naming a student for the leader, “Xie Wanying, you go first.”
Xie Wanying originally thought the leader would ask Doctor Song. As a student, she was eager to answer the question and swiftly, accurately retrieved the knowledge points in her mind:
“The liver’s function lies in the hepatocytes, and hepatocytes have a very rapid proliferation ability after partial hepatic resection; it can regrow half a liver in three months. Therefore, the liver can be divided into eight independent sections for donor purposes.”
Yes, everyone listened to her speak, noticing she became more fluent as she went, sounding a bit like a tape recorder.
“The eight segments are classified according to Couinaud segmentation, marked clockwise according to the portal vein system, specifically segment I caudate lobe, segment II left lateral superior, segment III left lateral inferior, segment IV left medial, segment V right anterior inferior, segment VI right posterior inferior, segment VII right posterior superior, and segment VIII right anterior superior. Besides guiding surgical operations, it is also used to guide CT imaging diagnosis. In practical operations, it is not possible to use all eight segments independently; surgeons commonly use left hemiliver segments I-IV, left lateral segments II-III, and right hemiliver segments V-VIII.”
Xie Wanying finished without any effort in one breath.
Clearly, the tape recorder she was mimicking replayed excellent textbook examples; her voice was clear and her enunciation precise, much like a teacher lecturing in a classroom.
The teachers, upon hearing her voice, felt as if a refreshing spring breeze caressed their ears, enjoying the listening experience, reluctant to move on and wishing to ask more questions. Hence, Associate Director Xue continued to ask her, “Now tell us, this patient has liver cirrhosis and is undergoing liver transplantation, our department also has patients with liver cancer, can they undergo liver transplantation?”
This question was even more practical, and Xie Wanying quickly thought it over before responding, “First, it must be noted that hepatocellular carcinoma, HCC for short, in most Asians is associated with hepatitis and liver cirrhosis backgrounds. From this perspective, instead of waiting for liver cancer to develop before treating it, it’s better to prevent and treat hepatitis early on and slow the progression of liver cirrhosis. When necessary, it is more advantageous to perform liver transplantation during the cirrhosis stage.”
Good, the answer immediately aligned with the clinical emphasis of the question, not just empty theoretical ramblings that intrigued even the old professors in attendance.
She was right, the surgeries done by doctors in the country are all for local patients, who of course have diseases characteristic of Asia. A clinical surgeon is required to act based on practicality, discussing issues starting from the existing clinical cases at hand. Indeed, this female medical student showed a significant sense of clinical enlightenment, not merely engaging in armchair strategies.
Associate Director Xue turned to glance at her, as if trying to memorize her features. After all, medical students like her were rare.
“Tell us, under what circumstances can liver cancer patients undergo liver transplantation surgery?”
Xie Wanying replied, “Small hepatocellular carcinoma can undergo transplantation, meaning liver cancers with a tumor diameter of less than five centimeters. Patients who undergo complete liver transplantation for this condition have a five-year survival rate of seventy to eighty percent. This offers certain advantages over traditional resection surgery. In the case of HCC, less than twenty percent of patients achieve radical cure with liver tumor resection.”
“What about other patients?”
“For mid-to-late stage liver cancer patients, especially those with portal vein tumor thrombus, the recurrence rate after transplantation is too high, and most do not survive a year. Since there is a scarcity of liver sources in the country, it’s best to apply the Milan criteria internationally proposed for the indications of liver transplantation for liver cancer.”