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Jiangmen Central Hospital
Surgery Record
Name: XXXX, XXXX      Bed Number: 1508Medical Record Number: 296643
Department: Hepatobiliary and Gastrointestinal Surgery Gender: Female    Age: 50  
Pre surgery Status: T: 36.2°C    R: 20 per minute   P: 82 per minute    BP: 114/66mmHg
Premedication: phenobarbital 0.1 with orcinol 0.3 mg/IM were taken before surgery.
PreoperativeDiagnosis: descending colon multiple primary cancers 2. Severe anaemia
Anesthesia: intravertebral anesthesia Anesthetist: YE, Hongli
The Operation Time: From 09:45  To  13:45,  17 Apr, 2008
Post Operation Diagnosis: 1. Transverse colon cancer  2. Descending colon polyp
Surgery: Left hemicolectomy
Surgery History: After successful anesthesia, the patient was in the supine position with surgical fiber. The tumor could be found, which was 8x6cm of size in the transverse colon closed to spleen, when cut on the left abdomen slowly. Descending colon polyp was palpated, which was 2x2cm of size when serosa infiltrated. A cystis was palpated, which was 1x0.5cm of size on the hepatophrenic surface. There was an offwhite nodule as the size of a grain of rice on the left side. Spleen and pancreas were impalpated without ascites. There were no planter curs in peritoneum and pelvic cavity. Left hemicolectomy surgery would be on progress. Right transverse colon was picked up to protect the incision. Then deal with greater omentum and open gastric colon ligament up to the edge of the pancreas. Deal with omentum tissues under the right vessel arches gradually. Stump was ligated bilaterally by filament of size 4 and 1. After that, move intestine and greater omentum with warm gauze of saline to expose left colon. Open the site between 乙-type mesocolon and left iliac fosse to dissociate乙-type colon. Meanwhile, open peritoneum behind the left edge of descending colon polyp. Dissociate the descending colon by the method of sharp dissection. Please take care to protect left kidney and ureter. Then cut the splenorenal ligament to dissociate splenic flexure of colon, while handle the end of vein under the mesenterium. Suture the stump by filament of size 1 after the bilateral ligation with the filament of size 7 and 4. Deal with the left vessel branch in colon and left colon vessel in the same way. Then handle mesenterium at the estimated site to cut intestine and suture the top of colon. It was satisfying if the anastomotic stoma could contain 2 fingers without tension. Stitch the transverse mesocolon and 乙-type mesocolon by interrupted single suture. Drainage tubes were beside the anastomotic stoma. Subcutaneous pump was placed on the left for intraperitoneal chemotherapy and bleed were stopped carefully. After that, flush operation area with normal saline. Active bleeding was not observed. Treat the wound and intestine by chitosan solution. Finally, check the instruments and fibers, and then close the abdominal cavity layer-by-layer. The operation was succeeded and the amount of bleeding was 200 ml. Return the patient after surgery and submit samples for analysis.

Time of Record: 15:30, 17 Apr, 2008
Operator: GONG, AAAAAFirst assistant: AAAAASecond assistant: Student
Record Doctor: AAAAA
Chief doctor: AAAAA
(Associate) Chief Physician: GONG, AAAAA
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Resident: BBBB
(Associate) Chief Physician: GONG, AAAAA