Cardiac Surgery of Beijing Union Hospital for patients with "bombs" for patients with cardiopulmonary tumor

The 28 -year -old guy, the tumor was from the lung minister to the heart, and was rushed to the brain, kidney, intestine, coronary arteries. Repeated tumor embolism causes chemotherapy to be unable to perform, and due to the widespread erosion of the cardiopulmonary, the surgery is extremely difficult. Xiao Liang, who has been seeking medical treatment in many places, hugs the last line and hopes to come to Beijing Union Hospital. Can he get a front line here? Recently, Miao Qi, the director of the Surgery of Beijing Union Hospital, jointly removed the cardiopulmonary tumor for Xiaoliang, and retained healthy lung leaves as much as possible through the original transplantation of autologous lung lobe, creating favorable conditions for the restoration of its postoperative recovery.

At the end of 2021, the symptoms such as cough and fever suddenly occurred. After receiving pneumonia -related treatment, the symptoms did not disappear. The doctor saw the huge place in the right lungs from the lung CT. He realized that the beam may suffer from lung tumors, but repeated puncture did not obtain exact evidence. When the doctor was still considering how to take the pathology, Xiaoliang suddenly had abdominal pain, enhancing the CT that the tumor had invaded the left atrium, and the blood vessel embolism caused the left kidney and intestine. Local doctors were unable to do it, and I suggested that Xiao Liang went to Beijing to try.

In just a few months, the young beams of young people have gone through pneumonia to lung cancer, to advanced lung cancer, and the tumor thrombus repeatedly falls off so that the embolism has been embold in an important organs. The most unacceptable thing is that Xiaoliang almost lost the opportunity for treatment.

Holding the last hint of hope, the Liang family came to the Syllabic Cardiac Surgery. After the Miaoqi team evaluated, Xiao Liang's lung -hearted tumor had great risks, regardless of conservative treatment or surgical treatment. At the same time, Xiaoliang's condition is extremely unstable, just like "bombs" from time to time, even if only a little fluctuations in blood flow and blood pressure may cause the tumor to fall off again and endanger life.

Considering that Xiaoliang is very young, and the family members have a strong willingness to treat, Miao Qi's team repeatedly evaluated that through surgery, the irregular "bomb" in the heart can be demolished, creating conditions for subsequent comprehensive treatment, and a pathological diagnosis. At the same time, if the complete resection of lung tumors can be completed during the same period, combined with subsequent chemotherapy, the best effect can be obtained.

However, accidents are always sudden. On the day of hospitalization, just because of the increase in the amount of activity before surgery, the beams had symptoms of chest tightness, chest pain, and temporary amnesia. The test results confirmed that the tumor fell off again, and the blood supply of the heart and the brain was embolized. The rapid progress of the disease has made treatment urgent. However, due to the extensive scope of tumor invasion in the lungs, if all right lungs are removed in order to reduce the difficulty of surgery, the survival and quality of life after the beam can not be guaranteed; It is also likely to affect the blood flow of the lungs, causing a wet gangrene in the lungs. The cardiac surgery team did not dare to delay for a moment, and quickly completed the pre -surgery evaluation and preparation. At the same time, the anesthesiology department, the ICU), the internal medicine of the oncology, the Department of Cardiology, the Department of breathing and the critical condition, and the thoracic surgery were discussed and treated. The plan has formulated a variety of plans for various situations that may occur during the operation.

▲ The huge lung tumor (blue arrow) has violated the surrounding chest walls, diaphragm, and pulmonary tumors (red arrows) in the left atrium

During the surgery, the tumor of the lungs of the small beam had violated the left atrium along the pulmonary vein, and at the same time infringed the important structures around the pulmonary, chest walls, and diaphragm. Essence The cardiac surgery team immediately changed his mind and chose to remove heart tumors and right whole lungs. However, in order to recover and the chemotherapy after Xiaoliangliang, the team touched the right upper lungs from the tumor violated and the right whole lungs. After the pulmonary blood vessels and bronchies were properly trimmed, the upper right lung was transplanted back to the chest cavity. Intersection

The surgery took 6 hours. With the recovery of pulmonary blood flow and ventilation, Xiaoliang finally got rid of the risk of death during the operation. The pathological results of the postoperative also confirmed the speculation of malignant tumors. Fortunately, all the cutting fate is negative!

After surgery, Xiaoliang's transplantation lung function was good, recovered quickly, and was discharged smoothly 10 days after surgery. At present, he has successfully completed the first chemotherapy and immunotherapy in the Department of Breathing and Critical Medicine.

▲ Two months after surgery, the blood flow and ventilation of the lung lobe on the right side of the patient are normal, and the activity tolerance and lung function are normal.

(Guangming Daily All -Media Reporter Cui Xingyi Correspondent Liu Jianzhou Zhao Yanxue Hong Chengwei)

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