Seeing skills in ordinary places and showing care in subtleties --- hard power + warm services to create a new experience for patients
On August 30, 2022, transvaginal biopsy for pelvic tumor was successfully performed by professor Wang Fangjun, the director of the minimally invasive interventional department of Guangzhou Royallee Cancer Center.
Review
Ms. Peng, 56 years old, had always been in good physical condition. She suffered from epigastric pain more than a month ago, and it got better after about 2 hours, so she didn't pay attention to it. But after that, she developed abdominal distension and intermittent abdominal pain. After taking rest, adjusting the diet and other measures, the situation still did not improve. The abdominal distension worsened, her food intake decreased, and her weight continued to decrease.
"I'm afraid I'm really sick!" This thought made Ms. Peng in chaos.
After many inquiries, she finally came to Guangzhou Royallee Cancer Center to seek medical attention from director Wu Aiguo of cancer surgery department.
During this examination, it was found that the patient had developed a large number of ascites, complex pelvic cysts, multiple uterine fibroids and other accompanying problems;
Ultrasound and magnetic resonance imaging show that: the tumor had abundant blood supply, and the gap between the tumor and surrounding structures was unclear; That adenocarcinoma cells were found in the ascites exfoliative cytology further indicated that the tumor was no longer limited, and it was difficult to remove completely with only one operation.
While tumor treatment is to compete with time for patients. How to determine the most appropriate and effective treatment plan for patients in the shortest time, so that patients can benefit more?
Multidisciplinary consultation to seek the best solution for patients
A multidisciplinary discussion ensued. Experts from the departments of internal medicine, surgery, gynecology, minimally invasive intervention, imaging, and ultrasound diagnosis all agreed that, although the diagnosis of patient with malignant tumor and adenocarcinoma has been confirmed, the grading, staging and genotyping must be clarified as soon as possible from the perspective of the need for fine treatment, to guide the formulation of local treatments such as surgery, interventional therapy, radiotherapy, and systemic treatment plans such as chemotherapy, targeted therapy, and immunotherapy.
To obtain these necessary diagnostic basis, a high-quality needle biopsy is essential.
At present, puncture biopsy under image monitoring also belongs to the category of minimally invasive interventional diagnostics. Therefore, professor Wang Fangjun, director of the minimally invasive interventional center of Royallee, to personally perform the operation became the common recommendation of experts from various disciplines.
Wang Fangjun
Introduction:
Former head of the interventional specialist department of the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, specialized for minimally invasive intervention, vascular surgery, hepatobiliary surgery. Key diseases: malignant tumors such as liver cancer and lung cancer, hepatic hemangioma, uterine fibroids, adenomyosis, cysts and other benign tumors and tumor-like changes; arteriosclerosis obliterans, diabetic foot, varicose veins, venous thrombosis and other vascular diseases.
Professor Wang Fangjun believes that the path selection of needle biopsy is a key part, and it is one of the basic principles to reach the target site with the shortest possible path. According to the patient's current imaging data, it is difficult to avoid the damage to the surrounding complex structures when choosing the transabdominal or translumbar approaches, and the transvaginal puncture approach is relatively shorter and safer.
However, the blood supply inside and around the mass is abundant, and the shortest puncture path is still difficult to completely avoid the risk of puncture induced bleeding. Therefore, the choice of ultrasonic real-time monitoring is the preferred method of guidance.
When the operation is performed in the DSA room of the minimally invasive interventional center, angiography can be performed immediately when necessary to ensure timely and effective interventional embolization for hemostasis.
Working together for safe sampling
On the day of the operation, the patient was escorted to the operating table in the DSA room as scheduled. Although this is only a minimally invasive interventional diagnosis operation, it adheres to the "customer-centered" service concept and takes into account the special situation of the patient, and to fully protect the patient,in addition to the medical, nursing and technical staff of the interventional department, the puncture process also brought together members of a multidisciplinary team from gynecology, surgery, and ultrasound department.
Kang Meihua, deputy chief physician of gynecology, disinfected the surgical area and exposed the surgical field;
The attending doctor Zhang Rao in the untrasonic diagnosis department, used a vaginal ultrasound probe to explore an optimal puncture direction, and used a transabdominal probe to closely monitor the whereabouts of the puncture needle;
Professor Wang Fangjun took the lead and successfully performed multi-point puncture with the attending doctor Liu Jinwen, and obtained enough samples for pathological sections, immunohistochemistry, and genetic testing. The patient had no adverse reactions during the whole process, and the ECG monitoring indicators were stable, and no postoperative bleeding sign was seen.
Sampling
Ms. Peng was touched by the collaboration of such a mature multidisciplinary medical team. "When you are sick, you feel that you are the most important person in the world, and everyone will more or less think you are hypocritical. But the doctors and nurses of Royallee made me feel strongly that they not only care for my illness, but also my feelings. They made me feel at ease, relieved and happy to be treated here."
The details of diagnosis and treatment are not trivial, because safety is no trivial matter, and no negligence or fluke mind is allowed. See the spirit in the subtleties, see the sincerity in the cooperation. Guangzhou Royallee Cancer Center always looks forward to providing its subtle and warm services for every patient, so that they can receive the best care and achieve the beautiful goal of recovery on discharge.
Contributed by: minimally invasive interventional treatment center
