You are too fat, the surgery is too difficult to do, why do surgeons 'discriminate' against fat people
Old Wu is 50 years old this year. He went to the hospital for examination because of blood in the stool. It was found to be rectal cancer. He had to undergo surgery. The doctor asked him to lose weight first.
I did abdominal and chest CT, and pelvic MRI. Fortunately, there was no metastasis to distant organs such as liver and lung, but pelvic MRI showed that the cancer had invaded the full thickness of the rectal wall, and there was pelvic lymph node metastasis, so it was considered stage III. Rectal cancer.
We recommend that he do concurrent chemoradiotherapy first, which can make the tumor shrink, improve the complete resection rate, reduce the recurrence rate, and increase the probability of preserving the anus. The effect of radiotherapy can last for a long time. Generally, it is recommended to rest for about 8 weeks after radiotherapy, and then do surgery.
We also made a request to him, that is, during this period, he must lose weight, because he is 170 cm tall, but his weight has reached 200 catties, and his body mass index has reached 34.6, which is seriously exceeding the standard. Moreover, Lao Wu is abdominally obese, with a big belly and neither arms nor thighs.
Why do we let Lao Wu lose weight? Because surgeons are full of "discrimination" against fat people!
For some obese patients, surgeons often say that surgery is not easy to do, why not do it, mainly for the following reasons:
- Obese patients with thick subcutaneous fat
Many obese patients have a lot of belly. Compared with thin people, the subcutaneous fat is obviously thick. For example, the subcutaneous fat of thin people is only 0.5 cm, and the fat is 5 cm thick.
During laparotomy, it takes one or two minutes for a thin person to enter the abdominal cavity, while for a fat person it may take more than ten minutes before the doctor can cut the skin, thick subcutaneous fat, muscle, and a thick layer of extraperitoneal fat. to enter the abdominal cavity.
During the operation, the patient's abdominal wall needs to be pulled to both sides, so that the organs in the stomach can be exposed, the diseased organs or tissues can be found, and then they can be removed.
We have a variety of instruments that are specifically designed to open a patient's abdominal wall, such instruments are called retractors.
Obviously, the thin belly of the thin person is easier to pull apart, while the belly of the fat person is too thick, and the doctor in charge of the hook will be very hard and require a lot of effort.
We once performed a rectal cancer operation, and the patient was also a fat man weighing more than 200 pounds. Two rotating students were in charge of retracting the hook. The operation was not easy to do. broken.
After the operation, a classmate said, I hate fat people! Another classmate himself is quite fat. He said that he must lose weight. If he gets sick in the future, he doesn't want to be like this patient.
After the lesion is removed, the abdominal cavity needs to be closed, and the surgical incisions are sutured layer by layer. In the fat man's operation, closing the abdominal cavity is also a technical task. The belly is thick and the tension in the abdominal cavity is high. Moreover, the blood supply of adipose tissue is not very good, and it is prone to incision fat liquefaction, incision infection, and incisional hernia.
- Obese patients have small abdominal space, which is inconvenient to operate
Fat people not only have a fat belly, but also have a lot of visceral fat in the abdominal cavity. The omentum and mesentery are all adipose tissue. Adipose tissue occupies a large amount of space in the abdominal cavity, resulting in a smaller space for surgical operations.
For example, during rectal cancer surgery, the rectum is already in the narrow pelvis. If the fatty tissue around the rectum is particularly hypertrophic, it may occupy the entire pelvic space. During the operation, the mesorectum needs to be freed from the pelvis, so that It is very difficult to operate.
At this time, it is easy to cause unclear anatomical levels, easy to damage blood vessels, damage nerves and other organs, cause secondary damage, increase the difficulty of surgery, and increase the incidence of complications.
Therefore, it is not only difficult for fat people to perform surgery, but also has a high incidence of complications. It is not that doctors discriminate against obese people. It is indeed that the operation is much more difficult than thin people. Especially obese patients, the surgery is not easy to do, for your health, Everyone must lose weight!