A Multi-disciplinary Treatment team of members from Gastrointestinal Surgery, Vascular Surgery, Anaesthesiology and Operating Room of the hospital defused the "bomb" in the upper abdomen of an 86-year-old patient with a radical colon tumor resection. The patient healed well after the operation and discharged from the hospital.
The male patient began with symptoms of cardiopalmus, hemafecia, and dizziness in May 2020. And the amount of bleeding was increasing, as many as four to five times a day. In addition, the old man had medical history of abdominal aneurysm and abdominal aortic dissection. After some twists and turns, he came to the hospital to seek the help in the Gastrointestinal Surgery Dept.in this March.
The old patient was in the bad situation when he arrived. Prof. CAI Kailin at Gastrointestinal Surgery Dept. said, "he had a lot of blood in the stools every day and was suffering from moderate to severe anemia." After several rounds of discussions and assessments, a group of experts led by Prof. CAI Kailin used gastrointestinal endoscopy and biopsy for him successfully and came up with a definite diagnosis in the end, that is, colon cancer.
Professors were performing postoperative examination for the patient
The old patient had serious underlying diseases, such as coronary heart disease, abdominal aortic dissection and several great vessel dissections, combined with aneurysm. The dissecting aneurysm had the potential to rupture any time, causing life-threatening hemorrhea. Gastrointestinal Surgery Dept. teamed up with the departments of Vascular Surgery, Anaesthesiology and Cardiology, and made out a precise treatment plan following several rounds of preoperative discussions, in an effort to perform colon tumor resection on the admirable old man safely as early as possible.
On April 6, Prof. ZHENG Hong and Prof. SHANG Dan, two experts from Vascular Surgery Dept., made the first move and performed the vessel defusing operation in the DSA Hybrid Operating Room. After accurately locating the lesion, the operation team successfully performed descending aortic aneurysm transluminal stent-graft placement, right common iliac artery aneurysm transluminal stent-graft placement, right internal iliac artery embolization, and left common iliac artery dissecting aneurysm transluminal stent-graft placement, and retained left internal iliac artery. These operations effectively maintained stability and safety of the vessels. "These operations lay a solid foundation for subsequent blood supply to the intestinal tract and the surrounding tissues after the sigmoid colon tumor operation." said Prof. SHAND Dan, Deputy Director of Vascular Surgery Dept..
Intestinal obstruction caused by the tumor needed to be released. Prof. CAI Kailin and Prof. WU Ke from Gastrointestinal Surgery Dept. took over the "relay baton". First of all, the patient was given accurate anaesthesia with the fewest adverse effects, providing safety assurance to tumor resection. The tumor was found to be large and blocking almost the entire colonic cavity during the operation. The colon above the tumor showed hydroncus owing to long time of expansion and obstruction. The doctors accurately cleared the surrounding lymph nodes. While removing the tumor completely, the organs' function were preserved carefully. The precise operation brought opportunity for one-stage intestinal anastomosis, restored the structure and function of the intestine directly and avoided two-stage operations. By then, the team of experts unclogged the life supply lines of the patient completely.
