Chapter 366 The helplessness of the dream team
In the conference room of the Sixth Hospital of Magic City, an intense case discussion was taking place.
Hong Zhigang presided over the event, with orthopedics, neurosurgery, surgical oncology, and medical oncology as the main subjects, while other departments such as cardiovascular medicine and respiratory medicine also attended.
Dean Chen of Moliu and Director Peng of the Medical Department both attended the meeting.
Among the many experts, there are also several experts who came from the United States for consultation.
The case discussed was none other than Academician Feng Tiancheng. Professor Feng was a leading figure in orthopedics in the country. Whether it was Moliu Hospital or Hong Zhigang personally, they would treat his disease at all costs.
Hong Zhigang invited Professor Johnathan from the Mayo Clinic Neurosurgery Department, Professor Griffin from the Anderson Cancer Center, and Professor Woodhead from the Twin Cities Spine Center from the United States.
To treat Professor Feng's disease, this team is undoubtedly the dream team in today's world.
Professor Feng's upper spinal cord and medulla oblongata tumors have invaded the respiratory and circulatory centers, causing breathing and heartbeat to slow down.
Once due to respiratory depression and arrhythmia, blood oxygen saturation could not rise, acid-base and electrolyte imbalance, he was sent to ICU for rescue.
After rescue, he got better after a period of ventilator-assisted breathing, and was extubated a week ago.
Currently, under oxygen inhalation, the blood oxygen saturation is maintained above 95%, and the acid-base and electrolyte balances are corrected. However, the heart rate and respiratory rate have been very slow and have not returned to normal. The heart rate remains at 50 beats/min and the breathing rate is 16 times. /point.
If the heart rate drops again, a pacemaker may need to be implanted, and if breathing is suppressed again, tracheal intubation and ventilator assistance will be needed again.
"The tumor has rich blood supply and originates from the upper cervical spinal cord. It grows aggressively through the skull base and into the medulla oblongata. The tumor has been mixed with the parenchymal tissue of the respiratory and circulatory center. During the resection, the respiratory and circulatory center will definitely be damaged."
"This is equivalent to peeling off the yolk from an egg without damaging the albumen. However, the yolk and albumen of this egg have been mixed together and penetrate each other. Who can completely peel the yolk out without damaging the albumen?"
"The breathing and heartbeat begin to slow down, and within a few months, they gradually tend to stop. If the bottom line of life is hit again midway or a foramen magnum hernia occurs, the patient will die at any time——"
Professor Johannesson from Mayo Clinic Neurosurgery spoke in American English.
He said it was a pity that there was nothing he could do to help. The Mayo Clinic's neurosurgery ranks No. 1 in the United States, and Johnathan is the best neurosurgeon in the world.
Professor Griffin from the Anderson Cancer Center, who is bald and obese, with a ring of sparse blond hair around his head, loosened his tie: "Before there is a pathological examination of this kind of chordoma, we will temporarily call it For chordoma, the current success rate of surgery is less than one percent. In other words, the success rate is close to zero. The very few successful cases are that the tumor and the respiratory and circulatory center are not obviously mixed. In Professor Feng’s case, even with laser surgery Knife cannot avoid injuries. No one can challenge this kind of surgery. It is currently a forbidden area for surgery. ”
Woodhead, who is at the Twin Cities Spine Center, is tall and thin and appears energetic. He points to the anatomical model on the screen and explains:
“Exposure is also a difficult problem. The neurosurgery’s occipital craniotomy exposure is connected with the posterior cervical spine exposure. The occipital craniotomy is opened to expose the medulla oblongata, and the upper cervical spine is opened to expose the upper cervical spinal cord. Then the upper cervical spinal cord and medulla oblongata are dissected, or no resection is performed. , removal is damage, the gangster and the hostage are mixed together, making it impossible for us to shoot.”
"Hong, I suggest that you give up the operation, maintain the status quo, and let nature take its course. Moreover, the patient is old and has been rescued once. His current state cannot withstand the impact of surgery. Moreover, the success rate of this operation is negligible, so the operation is meaningless. Can accelerate death-——"
Professor Johannesson spread his hands and said that everyone had tried their best and there was nothing they could do.
Dean Chen turned his eyes to Hong Zhigang. Hong Zhigang turned over the medical records in his hand and felt very unwilling. Is there really nothing he can do?
He knew that there was no need for a person who was almost eighty years old to fight for this surgery that had no chance of winning, but he didn't want to watch the teacher leave like this. He wanted to do something.
These top bosses in the world are helpless, which means they can really only watch the teacher leave. It is foreseeable that if the tumor is not removed, or persist for two or three months, or something bad will happen tomorrow.
At this time, Hong Zhigang's heart was burning and he was in unbearable pain. The teacher was so kind to him, but there was nothing he could do.
Although my mentor is almost eighty years old, judging from other physiological indicators, if it were not for this tumor, it would not be a problem to live for a few more years.
"Hong, when you sent me the patient information, I used virtual reality technology to conduct surgical simulations, but none of them were successful so far. They all failed due to respiratory and cardiac arrest during the process." Professor Johannesson spoke again.
The virtual reality he mentioned is currently the most advanced technology in the world and can simulate the anatomy and physiology of organs.
Then using virtual touch technology, surgeons can operate on virtual organs. If a certain part is cut, it will bleed and injure an important part. It simulates physiological interference and is closer to real surgery.
This is Professor Johannesson's magic weapon. When faced with ultra-high-risk surgeries, he will use this system to simulate.
However, no matter how realistic it is, this technology cannot simulate the truly complex human body. It can only perform simple simulations of physiology and anatomy. If the simulated surgery cannot be successful, it will be even less successful on the human body.
"Professor Hong?" Wen Rentao, who was standing next to him, saw something strange about Hong Zhigang.
A tear slowly seeped out from the corner of Hong Zhigang's eyes. He quickly took out a tissue and wiped it: "It's okay. Let's think of a solution. There is no way there is no way."
Many difficult surgeries, in his hands, turned danger into safety and finally succeeded.
The atmosphere in the entire venue fell into a dull mood. Today's meeting mainly focused on listening to the opinions of American experts. Experts from this hospital have discussed this many times. "It is recommended to use radiation for palliative treatment, which may prolong survival. If necessary, I can help arrange and recommend the EDGE non-invasive surgical system. I can help contact the Henry Ford Hospital Cancer Center in the United States." Professor Griffin broke the dullness.
EDGE non-invasive surgical system is the world’s most advanced tumor radiotherapy equipment.
"Thank you all, your opinions are very valuable, we will consider it again." Hong Zhigang stood up and bowed to everyone.
Several colleagues flew across the Pacific to come for consultation and help, but the condition was too serious. Doctors are human beings, not gods.
The consultation meeting adjourned and several American professors were led to visit the hospital.
"There's a call from the ICU. Mr. Feng wants to see you." Wen Rentao whispered to Hong Zhigang.
"Well, I'll come over for a moment. You stay with everyone. Have the MRI results of bed 16 come out?" Hong Zhigang asked.
"Come out." Wen Rentao knows the patients in the department well.
Hong Zhigang handed over the task of accompanying the American professor to Wen Rentao. He was very satisfied with this student's technical strength and communicative ability.
Hong Zhigang rushed to the ICU. Although the teacher was conscious, his heartbeat and breathing rate were still relatively slow. This was the interference of the tumor on the respiratory and circulatory center. He didn't know where this lifeline was. Once the lifeline was crossed, the teacher would leave.
Hong Zhigang put on an isolation gown, a hat, a mask, and shoe covers and entered the ICU.
Seeing Hong Zhigang arriving, Professor Feng stretched out his hand and said in a sober voice: "Zhigang!"
"Teacher, I'm here. I just finished the consultation. Professor Johannesson from the Department of Neurosurgery at the Mayo Clinic, Griffin from the Anderson Cancer Center, and Woodhead from the Twin Cities Spine Center discussed the surgical plan together. They are working on this aspect. With rich experience, the success rate of the operation is very high." Hong Zhigang helped the teacher organize the oxygen tube and held the teacher's hand.
Professor Feng smiled slightly: "Zhigang, you are serious. As doctors, we must seek truth from facts. Judging from the current reports, the success rate of surgery is less than 1% for my kind of complicated upper neck disease." There is no precedent for medullary and medullary bulbar tumors in our hospital. You don’t have to hesitate. Arrange the surgery for me. You will be the surgeon. If it fails, I will conduct an anatomical study on me after the surgery to thoroughly understand the pathological characteristics and surgical methods of this tumor. We will The level of surgery for complex tumors at the upper cervical skull base has been improved to a new level. Medical progress is full of risks and ups and downs. Even if I don’t have this disease, how many years can I live?”
"Teacher, please rest well. The EDGE non-invasive surgical system at the Henry Ford Hospital Cancer Center in the United States is more suitable for your situation. I am in contact." Hong Zhigang comforted the teacher.
"EDGE is ultimately a radiotherapy, and its accuracy is only 0.2 mm. There is no guarantee that the respiratory and circulatory center will not be damaged. If a laser knife is used for surgery, the chance of success is greater. The accuracy of the current laser knife has reached 0.1 mm or even lower. There is a glimmer of hope." Professor Feng is currently clear-headed.
"Has the MRI of bed 16 been released?" Professor Feng suddenly remembered the purpose of calling Hong Zhigang here.
"Come out!"
"Show it to me."
Professor Feng coughed a few times and tried to stand up. Hong Zhigang immediately held him down: "Teacher, don't move. I'll show it to you."
Hong Zhigang waved his hand through the glass door, and the ICU doctor came in immediately. Hong Zhigang said: "Please bring a tablet."
The doctor sent a tablet computer, and Hong Zhigang entered the hospital system, called up the patient's MRI, and then raised the teacher's bed slightly.
"I'm not used to seeing this," Professor Feng complained. He was used to watching films under a reading lamp, but now he lives in an ICU ward and has to make do with it.
"This is likely to be a solid hemangioblastoma. Be careful when resecting. These blood vessels are very large. Ligate the blood vessels while resecting. This is a dangerous area for the blood supply of the thoracic marrow. Pay attention to protecting the blood supply of the thoracic marrow, especially this root. Be very careful not to damage the blood vessels. Once damaged, the spinal cord will be ischemic and cause paralysis after surgery. Remember this! Is the surgery scheduled?" Professor Feng warned.
"It's arranged, Rentao will be the surgeon." Hong Zhigang helped the teacher press his legs and do ankle pump exercises. Lying in bed for a long time can easily cause venous thrombosis in the lower limbs.
"Rentao is a good kid, but after all, he is a young man and lacks experience. You have to go on stage to assist him. It is easy to fall into traps in this kind of surgery. You must not be careless." Professor Feng explained to Hong Zhigang carefully.
"He is stable. This tumor requires a microscope. He is now more stable than me in operating the microscope. But don't worry, I will be on stage." Hong Zhigang said with a smile.
Professor Feng put down the tablet and rested half-lying down, which could reduce the load on his heart.
"When you get better, I will take you to our countryside to rest for a month. Now is the time to fish in the river." Hong Zhigang chatted with the teacher while watching the monitoring screen.
"Oh, I'm afraid I can't go. You go and do your work. I'll take a nap."
Professor Feng squinted his eyes.
I have been writing slower recently, because the cases become more complicated as we go to the end, and the plot should be laid out slowly, with interlocking links and natural transitions, paving the way for and accumulating the following climaxes. The description of the case must be simple and profound, maintain a very high professional level, and be understandable by everyone without appearing boring. Recently, there have been many friends who have given rewards. I would like to express my gratitude by writing a single chapter when I have time. There is also a leader who has given rewards and I will update it after finishing these chapters.
(End of chapter)