Text/Yangcheng Evening News All-Media Reporter Lin QingqingCorrespondent Song Liping Cha GuanlinFigure/provided by the hospital
Xiaoqiu (Hua surname), an 8-year-old girl, is thinner than a child of the same age, weighing only 40 kilograms, but her stomach bulges like a volleyball, and the diameter of the "tumor" in her abdomen reaches 25 centimeters.
After examination, this "tumor" is a huge parasitic fetus and a rare congenital disease in the world. Genetically, it is also called "fetal fetus", and the incidence rate is about one in five hundred thousand. At present, only more than 200 cases have been reported in the global related literature.
A few days ago, the team of experts in gastrointestinal surgery of Guangdong Provincial Hospital of Traditional Chinese Medicine once again challenged the difficulty, and the giant tumor was successfully removed for Xiaoqiu in 65 minutes. Xiaoqiu recovered and was discharged 8 days after operation. This is also the first time that Guangdong Provincial Hospital of Traditional Chinese Medicine has completed the excision of giant parasitic fetus in children.
An 8-year-old girl is pregnant with a rare giant tumor.
On July 1st, last Saturday, Diao Dechang, director of Gastrointestinal Cancer Center of Guangdong Provincial Hospital of Traditional Chinese Medicine, turned down the invitation of academic lectures and drove to Lianzhou People’s Hospital for three hours. There are a pair of anxious parents waiting for him.
At the end of 2014, Xiaoqiu was born in a rural family in Lianzhou City. However, when she was one year old, the local doctor told her parents that Xiaoqiu was suspected of having a tumor in her body. Because of the poor equipment, it was impossible to clearly diagnose the size and nature of the tumor. Seeing that Xiaoqiu did not show obvious discomfort, Xiaoqiu’s parents took Xiaoqiu home with luck.
Since June this year, Xiaoqiu has always felt pain in her upper abdomen. Compared with her thin body, her stomach is getting bigger and bigger, and sometimes it is difficult to breathe, which seriously affects her daily activities. After examination by the hospital, it was found that Xiaoqiu had a huge "tumor" in his body, which severely oppressed the liver, great abdominal vessels and diaphragm, and the corresponding organs were severely squeezed and deformed. Due to the lack of relevant diagnosis and treatment experience, the local hospital contacted Diao Dechang, director of the Gastrointestinal Cancer Center of Guangdong Provincial Hospital of Traditional Chinese Medicine.
The moment I saw Xiaoqiu, Diao Dechang was shocked. In the thin body, the tumor is the size of a volleyball! Through abdominal examination, Diao Dechang felt the hard nodules like bones. The tumor was hard and could not be pushed, indicating that the tumor had formed dense adhesion with the surrounding organs and tissues, and even invaded the surrounding organs.
The results of imaging examination show that the tumor is located at the core of abdominal life, which pushes up against the heart and right lung, pushes forward and surrounds the inferior vena cava. The difficulty of the operation can be imagined, and it may damage the great blood vessels and endanger life at any time. Faced with this extremely difficult and risky case, Diao Dechang decided to transfer the little girl to Guangzhou for further diagnosis and treatment.
65 minutes of surgery successfully "disarmed"
After Xiaoqiu came to the Provincial Gastrointestinal Tumor Center of Traditional Chinese Medicine, preoperative CT showed that the tumor was located in the retroperitoneum of the right upper abdomen, which was considered as a rare giant parasitic fetus in the body, located in the retroperitoneal area behind the right liver, with a diameter of 25 cm. Because the parasitic fetus has already died, it has a neoplastic growth. The tumor wraps and pushes the inferior vena cava forward to the vicinity of the anterior abdominal wall, and pushes the abdominal aorta to the left severely. The liver was severely squeezed into an irregular sickle shape by the tumor, and the right kidney was squeezed downward into a triangle shape, so the renal blood vessels could not be distinguished. The diaphragm is also obviously squeezed upward and lifted upward, resulting in severe compression of the right lung and damage to the function of the right lung.
The most challenging thing is that there is no dividing line between the tumor and the organ, and the operation is very likely to damage the abdominal aorta or inferior vena cava and lead to massive bleeding and death. The anatomical separation of hilar region and hilar region is also extremely difficult, and unpredictable events may be fatal at any time.
At the same time, surgery is also a great test for children’s lung function and heart function. The removal of tumor will easily lead to the instantaneous expansion of peripheral blood vessels, which will lead to the decrease of blood return, which will lead to the decrease of blood pressure, and even lead to cardiac arrest in severe cases. However, the long-term compression of the tumor on the right lung leads to a serious reduction in the volume of the right lung, which is also an important problem that leads to lung dysfunction during and after surgery.
In order to ensure the smooth operation, the team of director Diao Dechang of the Hospital Gastrointestinal Cancer Center organized many discussions in the hospital. The anesthesiology department, pediatrics department, critical care department, blood transfusion department and other departments of the hospital conducted multi-disciplinary consultation before operation, and prepared sufficient surgical plans for various possible surgical situations.
At 9: 00 am on July 7th, Professor Diao Dechang performed the operation, with the assistance of Dr. Xiong Wenjun and Dr. Li Jin, and Professor Zhong Min presided over the anesthesia. When Diao Dechang opened the abdominal cavity, he saw that the thick inferior vena cava of the thumb was surrounded by the tumor at 270 degrees and pushed forward under the abdominal wall. Most of the tumors are surrounded by the liver, intestine and abdominal vessels, and only the palm-sized "tip of the iceberg" can be seen.
These pipes of children are as thin as toothpicks and may be damaged at any time. Diao Dechang successfully separated these pipes from the tumor by using the characteristic technology of the hospital-suction and curettage anatomy technology.
Subsequently, the surgical team carefully unwrapped the tumor from various wraps such as inferior vena cava and abdominal aorta. The tumor was completely removed! The operation took only 65 minutes and the bleeding was only 20 ml. Under the careful treatment of all the medical staff in the gastrointestinal surgery department of Guangdong Provincial Hospital of Traditional Chinese Medicine, Xiaoqiu was discharged from the hospital on the eighth day after the operation.
"Thank you so much! Director Diao, you are a great benefactor of our family! " When he was discharged from the hospital, Xiaoqiu’s father held Diao Dechang’s hand tightly and thanked him excitedly. (For more news, please pay attention to Yangcheng Pai pai.ycwb.com)
Source | Yangcheng Evening News Yangcheng SchoolEditor | Liang ShanyinProofreading | Zhu Aiting
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