Chapter 1033: 【1033】Rare Disease
The Boss spoke candidly.
“The angle is well chosen, allowing us to see everything clearly.”
Live surgery is not like any ordinary surgery; not only must it be clear for the Chief Surgeon, but it also needs to be comprehensible and vivid to the audience. Imagine the Chief Surgeon is a doctor within the team; even if the Mirror Assistant randomly changes the cara angle and the Chief Surgeon cannot see clearly, they can still infer from the patient’s condition assessed pre-operatively. However, the audience is different; without the Chief Surgeon’s understanding, they can only learn by watching the procedure unfold live.
The significance of the Mirror Assistant is highlighted once again.
This Mirror Assistant seems to be not only smooth in movents but also skilled technically, probably at a dium to high level.
Doctors from other hospitals imdiately understood: “Mmm, yes.”
That’s why Tao Zhijie would allow a relatively rare female doctor into his team. Surgery does not exclude female doctors; as long as they have superior skills and physical strength, no one is at leisure to gossip.
The silence and admiration from this group confird that Student Xiao Xie had made her point with capability, and the various baseless suspicions naturally dissipated.
The surgical image on the screen was now focused on the inferior vena cava, where everyone could clearly see the affected area.
Teacher Lu gently cleared his throat twice and said, “Looking at it this way, it appears to be a primary vena cava tumor.”
Kang Mingzhu passed her thermos to the teacher.
“No need,” Teacher Lu waved her off, clearly not in the mood for water.
The current surgical exploration results were not ideal; it wasn’t a situation without issues, hence no one was in a good mood.
It wasn’t a tastatic thrombus, but an extrely rare primary vena cava tumor. This type of disease is said to be mostly malignant, with leiomyosarcomas being the most common form in the inferior vena cava.
PIVCLMS, primary inferior vena cava leiomyosarcoma, has a prognosis as poor as tastatic cancers. Moreover, thods like chemotherapy have minimal effect on it, leaving surgical intervention as the only option to possibly extend the patient’s survival.
Nevertheless, not to ntion laparoscopic surgery, even traditional open surgery is very challenging to perform in such cases.
Tracing back to its origins, PIVCLMS starts in the smooth muscle of the IVC (inferior vena cava) wall. As the IVC wall is thin, it does not allow for debrident of the tumor, necessitating resection surgery instead. The resection needs to include the affected inferior vena cava, liver, kidneys, surrounding lymphatic tissue, and so on.
Just by considering the range of areas involved, one would sense the extre difficulty of the current surgery.
After all, the inferior vena cava is a major vein in human anatomy and is exceedingly long; if a tumor grows within, according to specialty classifications, multiple surgical specialty areas would need to be involved.
There are physicians who theorize the inferior vena cava can be divided into four segnts based on this condition, from bottom to top.
The first segnt extends to the plane of the renal veins; the second segnt spans from the opening of the deep veins to the Porta Hepatis; the third segnt stretches from the Porta Hepatis to the diaphragm; and the fourth segnt goes from above the diaphragm to the right atrium. The first segnt falls into the purview of urology, while the second may involve both urology and hepatobiliary surgery. By extension, the third is chiefly a matter for hepatobiliary surgery, and the fourth segnt would require thoracic surgery intervention.
Returning to the current surgical case, based on the CT angiography results and the clear Bud-Chiari syndro in the patient, the tumor obstruction mainly occurs in the third segnt of the inferior vena cava, thus falling under the purview of hepatobiliary surgery.
At this point, the hepatobiliary surgeon needed to further clarify during exploratory surgery whether the tumor was growing within the vein, outside the vein, or both.
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