再次手术

第五十章 再次手术

1.The last man to see the necessity for re-operation is the man who performed the operation.

—— Mark M.Ravitch, 1910——1989

【译文】最后一个认识到再手术必要性的是上次做这个手术的人。

【点评】否定自己总是最难的。因此,为保证对病情判断的客观性,再手术的决定和实施最好由另一位医生来主导。

2.It is painful to re-operate on your own complications; it is fun to do on complications of another surgeon.

—— Moshe Schein

【译文】为自己(的患者)的并发症再次手术是痛苦的,但为另一位外科医生(的患者)的并发症而再次手术却充满乐趣。

3.A negative re-laparotomy is better than a positive autopsy but is not,nevertheless, a benign procedure.

—— Roger Saadio

【译文】尽管阴性的再次剖腹手术比阳性的尸检好,但毕竟不是一桩好事。

4.This guy is too sick not to be re-operated upon.

【译文】这家伙虚弱得经不住再次手术。

【点评】患者再次手术的耐受性是优先要考虑的。

5.Frequent dilemma: take your wife for dinner or the patient back to the OR?

【译文】(外科医生)经常左右为难:是与夫人共进晚餐,还是把患者再推回手术室呢?

6.It's better to save a patient in two operations than killing him in one.

—— Hernan Diaz

【译文】如果两次手术能挽救患者总比一次手术死掉好。

7.A surgeon ...is like the skipper of an ocean-going racing yacht.He knows the port he must make, but he cannot foresee the course of the journey.At every stage he must have a plan, based on a working knowledge of his present position,that will allow him to make for the best of several available harbours should things go wrong, or if none is suitable he must know where to find temporary refuge under the lee of the land till he can resume his journey.

—— William Heneage Ogilvie, 1887——1971(https://www.daowen.com)

【译文】外科医生……就像一艘远洋帆船的船长。他只知道必须到达的港口,但他无法预见旅途的全过程。每一个阶段,他都必须根据目前所处位置做一个计划,如果事情出了问题,这将有助于他在几个可停泊港口中选一个最好的。如果都不合适,他必须知道哪里有一个避风的临时避难所,可以让他等到重新开始他的旅程。

【点评】再次手术也是一次航程的修正。

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8.Early re-operation is a double-edge sword.We have to learn how to use only the edge facing the enemy, the uncontrolled source。

—— Moshe Schein

【译文】早期再手术是一把双刃剑。我们必须学会只将剑刃对着敌人,即失控的根源。

9.In re-operative surgery, timing is everything.

—— Timothy Fabian

【译文】说到再手术,时机就是一切。

10.You do not drive in a foreign country without a map; why should you explore a previously operated abdomen without consulting the operative note?

—— Moshe Schein

【译文】没有地图你无法在国外开车,那为什么你没查阅手术记录就敢探查上次手术过的腹部呢?

11.When the wound scar looks mature so are the adhesions inside: supple and bloodless.

—— Moshe Schein

【译文】当(体表)伤口瘢痕看起来成熟时,意味着里面的粘连也大致如此:柔韧而不充血。

【点评】柔韧而不充血的粘连有利于再次手术。

12.He who operates and runs away, may get to re-operate on the same patient another day.

—— Moshe Schein

【译文】做完手术就匆匆溜走的人,可能有一天他还得回来给这个患者做二次手术。

【点评】善始善终坚持完成一台手术的每一步,是外科医生的一种优秀品质。