Check-in at the Hospital: The First Surgery Shocked the Nation!

Chapter 468 - 345: Surgical Treatment, Qin Feng Operates Again

The next day,

Having just completed his shift early in the morning, Qin Feng did not go home.

The little girl from yesterday has already been admitted and is now in the emergency department.

Today’s task is to complete the discussion of the surgical plan, to be decided by the child’s parents.

"Director Sun, I’ve received your call early in the morning."

Qin Feng was sorting medical records in the conference room when a pleasant voice pushed the door open and entered his ears.

"Director Sun, sorry to bother you so early."

He quickly stood up and greeted them proactively.

It was none other than the Deputy Director of Pediatrics, Sun Wenhong, who was over fifty years old and amiable.

"It’s okay, I heard from Dr. Zhu that it was a little girl with a hypothalamic hamartoma."

"Yes, otherwise, I wouldn’t bother you to come over."

Qin Feng nodded.

"Hmm, this case is indeed very valuable. Although Peking Union Medical College Hospital is well-known, our pediatrics is indeed not strong nationwide.

The best place for hypothalamic hamartomas is Xiangya Hospital, and even here in Beijing, it’s not as good as Military General Hospital and Friendship Hospital.

You still kept the patient, so it seems you are confident, haha~"

Sun Wenhong nodded with a friendly smile.

"Director Sun, you overestimate me. Although this is a neurosurgical operation, the patient is still within the scope of pediatrics.

Even at Xiangya, it is under the responsibility of pediatrics, with neurosurgery taking the lead."

Upon hearing this, Qin Feng immediately shifted the conversation, pushing all this to Sun Wenhong.

"Director Qin, you have a bright future ahead, hahaha~"

Sun Wenhong’s face blossomed into a smile upon hearing this.

Qin Feng did indeed have personal motives!

However, it was not for himself or the emergency department; this type of case is indeed a rare opportunity for pediatrics.

It’s also his first encounter, although he has countless memories in his mind, doing it himself is different.

"What are you two directors so happy about chatting?"

At this moment, Director Pan from neurosurgery also arrived.

"Oh, Old Pan, you’re early too."

Seeing him, Sun Wenhong also greeted him proactively.

"Old sister, since you’re here, I had to hurry over."

Pan Hai responded politely with a smile, then looked at Qin Feng.

"Director Qin, I heard it’s a hypothalamic hamartoma this time? This is a rare opportunity.

Ever since you became the deputy director of the emergency department, our surgical emergency has become much easier. Last time, we said we should gather the directors when you have time, to properly thank you, hahaha!"

"Director Pan, you’re too kind, it’s my duty."

Qin Feng nodded with a smile, then invited the two,

"Let’s sit down and first study this surgical plan. I’d like to hear both of your suggestions."

"Okay."

"Let’s sit."

The three sat down and began reviewing all of the little girl’s test results and related cases.

The surgical plan is a significant issue concerning the ultimate safety of the patient, so every step must be thoroughly and confidently advanced.

Moreover, hypothalamic hamartoma surgery is one of the more difficult types of surgical procedures, mainly due to the tumor’s special location, and the high risk during the operation.

Due to the abnormal development of neurons and the large amount of connected brain tissue around, with ambiguous boundaries, surgery becomes very complex.

Often, it is easy to fail to cleanly remove the tumor.

If the surgery is not precise, removing too much will damage other brain tissues, leaving the patient with serious sequelae.

Therefore, for hypothalamic hamartoma surgery, there are currently about three commonly used global methods.

Traditional treatments include direct craniotomy, pterional approach, subtemporal approach, or tumor resection through the interhemispheric transcallosal fornix approach.

There is also endoscopic trans-third ventricle tumor resection, among these two.

However, surgical excision has certain limitations.

From an electrophysiological perspective, hamartomas are a common epileptogenic focus, and affected children typically exhibit gelastic seizures, with severe cases potentially experiencing generalized tonic-clonic seizures.

Especially strong is the epileptogenic nature at the tumor margins, and if the tumor is not thoroughly removed, premature development problems will reoccur, with potential epileptic symptoms.

"Director Qin, although this tumor is relatively large, I still recommend trying SRT."

Neurosurgery Director Pan Hai examined the materials and spoke up,

"Director Sun, what’s your opinion?"

"I’ve also carefully reviewed this patient’s condition; Director Pan’s suggestion of SRT is indeed a viable option, but I do have a concern."

Director Sun Wenhong paused for a few seconds, frowning slightly,

"Currently, SRT may not completely clear such a large tumor in one go; if a second clearance is needed, wouldn’t the risk be higher?"

Upon hearing this, Qin Feng nodded as well.

SRT, or stereotactic radiotherapy, is a radiation treatment method and a common surgical approach for hypothalamic hamartomas.

It utilizes non-coplanar multi-field unit-focused radiation with multiple segmentation treatments, allowing the target area to receive a high dose while minimizing exposure to surrounding normal tissues, a therapeutic approach.

Primarily applied to malignant brain tumors, large tumors, and various malignancies in the body, it is a form of biological therapy.

It has distinct advantages.

With high precision, accurate positioning, three-dimensional treatment planning systems, and precise setup, it is clinically referred to as precise radiotherapy.

Most importantly, it is non-invasive, safe, effective, minimally painful for patients, and requires short hospital stays.

Compared to conventional radiotherapy, normal tissue exposure is minimized, improving local control rates and patient quality of life.

However, in China, SRT is more suitable for treating tumors smaller than 2 cm in the case of hypothalamic hamartomas.

If the tumor exceeds 2 cm, usually a second targeted radiation is needed.

But this poses a dangerous problem, as secondary radiation could damage surrounding nerves.

"However, if conventional surgery is chosen, even using an endoscope, the difficulty remains extremely high, with significant risks."

Pan Hai continued,

"Director Qin, what’s your view?"

Seeing that both Pan Hai and Sun Wenhong were looking at him, Qin Feng shared his thoughts.

"Both directors, actually for these hamartomas, although SRT is indeed the commonly used international treatment method,

Director Sun also mentioned that given the size of this tumor, it is challenging to destroy it in one attempt.

If a secondary destruction is done, the risk is actually not much less than that of surgical removal."

"Personally, I am more inclined toward the endoscopic removal method."

Upon finishing, Director Pan also nodded in agreement.

Currently, only these two surgical options are available, and it comes down to which procedure is more suitable for the patient.

"But, if we opt for endoscopic surgery, can we guarantee success?"

The room fell silent at this question.

Indeed!

SRT’s greatest advantage is that it does not place stringent demands on the lead surgeon, since the destruction electrode can be accurate to 0.5 mm, requiring only placement to destroy the tumor.

However, endoscopic surgery presents an extremely challenging demand for the lead surgeon!

This requires the lead surgeon to have a very high level of surgical skill, as the hypothalamus is one of the most vital organs in the human brain.

Even a small error can lead to severe lifelong sequelae for the patient.

"Director Sun, can you perform endoscopic surgery?"

Pan Hai immediately looked at Sun Wenhong.

"This... the difficulty is indeed very high."

Director Sun sighed; for her, it was undoubtedly a challenging task.

"The risk of endoscopy is too great; even in our surgical department, we can’t guarantee it."

Pan Hai also shook his head helplessly.

This tumor is too closely connected to the surrounding hypothalamus, and even a slight error can lead to a medical accident.

"Director Qin, you’re recognized as a surgical talent in our hospital, do you think we can pull it off?

If not, we’ll just have to give up."

Sun Wenhong seemed a bit disappointed, as even they were not confident about the surgery.

It’s too difficult!

If only the tumor were slightly smaller, it could be destroyed through SRT; the hospital has the means for that.

Looking at the complex expressions on both faces, Qin Feng showed a faint smile.

"Both directors, I can perform the endoscopy, but the final decision whether to proceed should be made by the family."

"Really?"

Upon hearing this, Sun Wenhong was momentarily stunned, then a look of joy flashed in her eyes.

Qin Feng could actually take the lead!