We make choices every day
Choose what to eat for three meals a day
Choose what to wear when you go out
…………
But the choice of life
It's not just about life
The First Affiliated Hospital of Zhejiang University School of Medicine
The vast majority of people face it
It's a life-or-death choice
It is the last glimmer of hope for survival
The 68-year-old Uncle Qiu (pseudonym) unfortunately found a huge thyroid tumor, and has been oppressed and invaded the esophagus and airway, and has no way to seek medical treatment in many hospitals. In the Department of Oncology surgery of the First Hospital of Zhejiang University, the doctor's plan can remove the tumor, but Uncle Qiu may not be able to speak again for the rest of his life, the crossroads of life, and finally he chooses...
001
Uncle Henan suddenly couldn't eat
It was caused by huge thyroid cancer
Uncle Qiu is a native of Henan, and in order to take care of his grandson in recent years, he has been following his son Xiao Qiu (pseudonym) and settling in Guangdong and living a happy life.
But since the second half of last year, Uncle Qiu, who has always been healthy, has felt that he can't eat. "In fact, it is not that his appetite has deteriorated, that is, his throat is particularly sore when he swallows things, and he can only eat semi-fluid foods such as porridge and noodles." Xiao Qiu said that the family thought it was inflamed at first, but the anti-inflammatory drugs they took for a while did not improve, plus after a few months, his father also had a breathless breath and was often awakened at night, and they made their first choice: to seek medical treatment.
In the local hospital in Guangzhou, endoscopy found that Uncle Qiu's esophagus had a huge lump, suspected to be esophageal cancer, but the subsequent pathological biopsy results found that he was suffering from thyroid cancer, and the lump was 5-6 cm large, which had been oppressed and violated the esophagus and airway, making the esophagus and trachea narrow as "a line of heaven", resulting in difficulty in swallowing and poor breathing.
"The doctor told me that my father's condition was very serious, but their skills were limited, and suggested that we rush to other major hospitals for treatment." Good luck did not come to this unfortunate family, and they were told that Uncle Qiu's tumor was not only large, but also invaded other tissues and organs, and the operation was difficult, and it was recommended to treat conservatively.
"In my eyes, this means that my father was sentenced to the 'death penalty', but I am not willing, China is so big, there must be a hospital that can be treated." Xiao Qiu accompanied his father to guangzhou for treatment while searching for information on the treatment of thyroid cancer on the online platform.
002
I searched for medical treatment to no avail
A short video lights up hope
"It is also magical to say, one day I opened the short video platform, the first video is Dr. Yu Xiongfei's popular science, I clicked in to see, many patients are full of praise for his thyroid cancer surgery." Dr. Yu Xiongfei, mentioned by Xiao Qiu, is the deputy director of the Department of Oncology Surgery of the First Hospital of Zhejiang University and has rich experience in the field of tumor surgery. With the mentality of trying it out, he chose to send a private chat message to Dr. Yu.
"I didn't expect him to reply to me that night, and we also successfully added WeChat." Recalling the situation at that time, Xiao Qiu was still excited.
"The patient's local examination is actually very comprehensive, and I think there are indications for surgery after evaluation." Deputy Director Yu Xiongfei explained that the local examination results have been clear, Uncle Qiu got eosinophilic carcinoma, which is a rare malignant thyroid cancer, insensitive to radiotherapy and chemotherapy and other treatment methods, the only treatment method is surgery, although it violates the esophagus and airway, causing great challenges to surgery, but these are local metastases, no lung metastasis, bone metastasis and systemic spread, coupled with the unique multidisciplinary combination treatment model of Zhejiang University First Hospital, the chance of surgical cure is still quite large.
The doctor's professional explanation rekindled the hope of Uncle Qiu's family, who immediately chose to go to Hangzhou and the First Hospital of Zhejiang University.
003
Multidisciplinary collaborative surgical excision
In order to survive, he chose...
After an outpatient interview and re-evaluation, Uncle Qiu was admitted to the hospital. After systematic re-evaluation of enhanced CT, MRI, PET-CT and gastroscopic tracheoscopy in the hospital, the patient was diagnosed with locally advanced thyroid cancer, which violated the trachea, esophagus and larynx, and was in danger of life at any time such as airway compression and asphyxia. Whenever such "big", "difficult" and "complicated" patients are encountered, Professor Teng Lisheng, director of the Department of Oncology Surgery of the First Hospital of Zhejiang University, will personally organize multidisciplinary consultations and formulate the best surgical plan.
After many consultations and discussions in multiple disciplines such as oncology surgery, tumor radiotherapy and chemotherapy, otolaryngology, thoracic surgery, intensive care ICU, anesthesiology, blood transfusion, operating room, pathology and imaging, the doctor formulated a plan for Uncle Qiu to "expand the radical resection of giant thyroid cancer, combined resection of tracheoesophagus and laryngeal organs, and gastric esophageal pharyngeal anastomosis".
Such a major and difficult operation needs to be carried out from the abdominal cavity, chest cavity and neck, which is also a great challenge for the surgical team: the doctor must first make the stomach into a "tubular stomach" in the patient's abdomen, then remove the esophagus invaded by the tumor from the chest, and finally remove the huge tumor and the invaded tracheoesophagus and larynx from the neck, pull the "tubular stomach" to the neck and sutured with the oropharynx, replace the esophageal function, and at the same time perform a permanent ostomy in the neck to maintain breathing.
"The doctor said that this surgical plan would also remove his father's pharyngeal part and vocal cords, causing him to be unable to speak for the rest of his life, but for us, this is his last hope for life." Xiao Qiu said that without surgery, the father may only have a few months to survive, but the operation can prolong his life, and may even be completely cured, between living and living better, the father himself made a choice: to live.
Not long ago, the team of Professor Teng Lisheng and the team of Professor Zhou Shuihong, director of the Department of Otorhinolaryngology, joined forces, and the teams cooperated sincerely to successfully complete the operation, Uncle Qiu recovered smoothly, and was successfully discharged from the hospital 10 days after the operation. "The operation achieved R0 removal, that is, the tumor and the invading tissue, including regional lymph nodes, were completely removed, and no tumor tissue remained in the body after the operation." Professor Teng Lisheng said that Uncle Qiu needs to continue to receive isotope iodine therapy, thyroid suppression therapy and long-term regular follow-up follow-up after surgery.
Uncle Qiu took a group photo with Professor Teng Li before he was discharged from the hospital
004
Thyroid disease is no small matter
Experts give health advice
How did Uncle Qiu's condition develop to such a serious point, and what kind of wake-up call can this bring us?
It turned out that before the first medical treatment, Uncle Qiu had already felt neck discomfort for a while, but it had not attracted attention, which gave this malignant tumor an opportunity to take advantage of, resulting in rapid progression of the disease.
"In recent years, the incidence of thyroid diseases has become more and more high, through this case, I also want to remind everyone that once thyroid disease or neck discomfort is detected, we must seek medical treatment in time." In the view of Professor Teng Lisheng, even if thyroid diseases are very common now, there are many treatment methods and the effect is relatively good, but there are still many types of diseases of unknown nature, which must not be taken lightly, if Uncle Qiu can go to the doctor at the beginning of his illness, timely discovery, and timely treatment, perhaps you can avoid this major operation, and it is likely to obtain a higher quality of life.
He further said that the detection of thyroid diseases must find a professional treatment team to diagnose, develop a standardized treatment plan, even if it is thyroid cancer, most of the current thyroid cancer can achieve a high cure rate and survival time after treatment, and even if there is a systemic metastasis, there are many treatment methods that can help patients to varying degrees.
Expert outpatient arrangements of the First Hospital of Zhejiang University
This article is the original of the First Hospital of Zhejiang University