Medical news July 15: Hope for late-stage cancer patients

Vinmec Central Park saves life for patient with large ovarian tumor

But thanks to a systematic treatment strategy and advanced surgical techniques, doctors at Vinmec Central Park (HCMC) successfully performed a major surgery, completely treating the malignant ovarian cancer with complications of colon fistula.

This is a very dangerous medical condition, once considered "incurable".

The doctor is consulting the patient.

Recently, Ms. LTĐ was admitted to Vinmec Central Park International General Hospital with prolonged abdominal pain, fatigue and a weight loss of 7 kg in just 3 months.

Through examination, the doctor discovered a 10-12 cm abdominal tumor, located in the left ovary and classified as having a high risk of malignancy (ORADS 5). Ultrasound images and clinical examination also showed that the tumor was firmly attached to the colon, with gas inside, an extremely rare sign in ovarian tumors, raising suspicion of a fistula.

BSCKII Nguyen Chi Quang, Head of Obstetrics and Gynecology Department (Vinmec Central Park) explains in detail about tumor images and the treatment process for patients.

Instead of intervening immediately, the doctors performed an MRI and colonoscopy to determine the exact situation. The results confirmed the initial concerns: there was a fistula between the colon and the ovarian tumor. If surgery were performed immediately, the risk of fecal leakage, peritonitis, and the need for an artificial anus was very high.

Given the patient's state of exhaustion, anemia, and malnutrition, the multidisciplinary team decided to postpone surgery to focus on improving his physical condition before surgery.

In the 7 days before surgery, the patient received comprehensive care from blood transfusion, iron supplementation and nutrition under close coordination between the departments of Hematology, Nutrition, ICU, Anesthesia, Gynecology, and Gastroenterology.

When the patient's condition was stable, the Vinmec medical team performed a 6-hour major surgery with the coordination of Dr. Nguyen Chi Quang (Head of Obstetrics and Gynecology Department), Dr. Nguyen Van Nghia (Digestive Surgery), expert William A. Casteleins and the Anesthesia and Resuscitation team.

The tumor was firmly attached to the rectum, pelvic wall, and the entire sigmoid colon (part of the large intestine). During dissection, a perforation was discovered in the colon, as diagnosed.

The team simultaneously performed two major surgeries: hysterectomy, two adnexa, left colon, greater omentum resection, and pelvic and aortic lymph node dissection. In particular, the doctor used an automatic intestinal stapler to help re-establish digestive circulation during surgery, helping the patient avoid temporary anal opening, shortening recovery time.

“If we split the surgery into two sessions, the risk is very high. The best solution is to combine the treatment thoroughly in one session,” said Dr. Nguyen Chi Quang, Head of the Department of Obstetrics and Gynecology.

After surgery, the patient was cared for in the Intensive Care Unit, closely monitoring her nutritional status and rehabilitation. Thanks to effective coordination between multidisciplinary teams, Ms. D. recovered well, was mentally stable, and had regular check-ups after discharge.

“I am very grateful to the doctors at Vinmec. Not only are they highly skilled, they are also very dedicated and attentive. Now my health is almost back to normal,” Ms. D. said emotionally.

With modern equipment such as MRI, Hybrid operating room and a team of experienced experts, Vinmec is one of the few medical facilities in Vietnam capable of performing complex major surgery with high precision.

Suffering from allergic rhinitis for 2 years due to a familiar "culprit" in the house

A 9-year-old boy in Ho Chi Minh City has just been diagnosed with allergic rhinitis that has lasted for 2 years, caused by a very common but often overlooked agent: house dust mites.

This case was discovered and treated at MEDLATEC Go Vap General Clinic, and at the same time sounded the alarm about subjectivity in preventing respiratory diseases in children.

The patient is NQH (9 years old), for 2 consecutive years, symptoms of itchy nose, sneezing, runny nose, especially worse when the weather changes, when exposed to dust or cigarette smoke.

Recently, the stuffy nose condition became more serious, causing the baby to have to open his mouth to breathe while sleeping, accompanied by phlegmy cough, fatigue, forehead headache and poor sleep. The family took the baby to MEDLATEC Go Vap General Clinic for examination and treatment.

Through clinical examination and imaging techniques, the doctor discovered that the nasal mucosa was pale and uneven, with fluid accumulating at the floor of the nasal cavity. The CT scan of the sinuses showed that the child had maxillofacial sinusitis, bilateral thickening of the inferior nasal turbinate mucosa, left sphenoid sinus polyps, and left middle turbinate sinus.

Endoscopy images showed red, swollen, inflamed mucosa. Notably, the results of the 53 allergen panel test showed a high specific IgE index, strongly positive for house dust mite allergen. The doctor diagnosed the child with perennial allergic rhinitis due to house dust mite allergy.

After determining the cause, baby H. was treated with anti-inflammatory and anti-allergy drugs and instructed to change the living environment to reduce exposure to allergens. The baby was also monitored for regular check-ups every week.

After nearly 1 month of treatment, symptoms such as stuffy nose, runny nose, night cough... have significantly improved. The baby eats and sleeps better, no longer has discomfort in the sinus area, health and quality of life have significantly improved.

According to Master, Doctor Tran Minh Dung, ENT specialist, MEDLATEC Go Vap General Clinic, allergic rhinitis is a very common disease, affecting 10-30% of the population in developed countries.

The disease can start as early as 2 years old, increasing with age, and is often confused with the common cold due to similar symptoms. Although not life-threatening, prolonged illness seriously affects the sleep, learning and daily activities of young children, and increases medical costs for the family.

Among allergens, house dust mites are a common but easily overlooked “culprit”. Dust mites are microscopic creatures of the arachnid family, invisible to the naked eye, often hiding in blankets, pillows, mattresses, carpets, curtains, stuffed animals, etc.

Their food is the sloughed skin cells of humans and animals. For children with allergies, even a very small amount of dust mites can trigger an inflammatory reaction, causing prolonged respiratory symptoms if not detected and treated promptly.

To prevent allergic rhinitis, Dr. Dung recommends that parents should proactively improve their children's living environment by taking some measures such as: using dust mite-proof covers for blankets and pillows with fabric fibers ≤6 microns; washing sheets and pillowcases with hot water ≥55°C weekly; vacuuming with a machine with a HEPA filter;

Keep indoor humidity below 50%; avoid using a humidifier and minimize stuffed animals and curtains in the bedroom. In addition, dust mite control measures can be applied using heat, a dryer or special chemicals under research such as emamectin 0.1%.

Finally, parents need to equip themselves with knowledge to recognize early signs of allergies such as prolonged sneezing, stuffy nose, night cough, clear runny nose... and take their children to an ENT or Allergy - Immunology specialist for timely diagnosis and treatment.

Choosing a reputable medical facility plays a key role in determining the exact cause and developing an effective treatment regimen, helping children recover quickly and develop healthily.

Bone graft to save severely damaged knee joint

Many years of untreated knee osteoarthritis caused severe joint deformity, forcing the 55-year-old woman to use a wheelchair for a long time. Thanks to bone grafting and knee replacement at the hospital, she was able to walk normally just a few days after surgery.

Ms. Hong, 55 years old, living in Ho Chi Minh City, suffered from knee osteoarthritis for many years but did not treat it completely, only using temporary painkillers. When she went to the hospital for examination, her condition was at a severe stage, forcing her to move around in a wheelchair. Her left knee joint had degenerated to the point where she could not bend or stretch, her leg axis was bent inward, her gait was completely distorted, affecting her spine and causing back pain.

Dr. Dang Khoa Hoc , Head of the Department of General Orthopedics and Traumatology, Tam Anh General Hospital, Ho Chi Minh City, said that the most serious point in this case is that the medial tibial plateau has a large defect, leading to instability of the joint structure. "This is the result of being subjective with prolonged joint pain, a common mistake in the elderly, causing the disease to progress silently to the point of being difficult to recover," the doctor said.

After a specialist consultation, the doctors decided to replace the knee joint with an artificial one to restore mobility to the patient. However, due to the large defect in the tibial plateau, the first option was to use a special type of joint that rarely required bone grafting but was expensive and difficult to replace a second time if necessary.

To balance treatment effectiveness and cost, doctors choose the conventional artificial knee replacement method combined with autologous bone grafting, which means taking bone from the patient's own body to compensate for the missing bone area.

To limit pain and blood loss, and to avoid having to remove too much bone (which affects the donor area), Ms. Hong was given an artificial wedge for reinforcement.

During the surgery, the doctors used the subvastus incision technique, lifting the quadriceps muscle instead of cutting the muscle, helping the patient reduce pain, reduce bleeding, and allow for early exercise and rapid recovery. At the same time, the patient's leg axis was readjusted, helping the two legs to be even and restore a natural gait.

On the first day after surgery, Ms. Hong was able to stand up and walk without a wheelchair. She shared that she felt a clear change: her legs no longer hurt, she was more balanced and flexible when walking. After two weeks of follow-up, both her knee joints and spine were stable, her back pain was gone, and her quality of life had improved significantly.

However, according to Dr. Dang Khoa Hoc, surgery is only part of a comprehensive treatment process. Patients need to follow rehabilitation instructions, avoid heavy lifting, pay attention to fall prevention, and have regular health check-ups to control degeneration in other joints.

Doctors recommend that the elderly, especially women, should be screened for osteoporosis annually and see a specialist immediately if there are signs of prolonged joint pain.

Early detection will help with conservative treatment with medication, physical therapy, weight control and lifestyle modifications. If these methods are not effective, surgery will be necessary. When intervened at the right time, the recovery is very effective, the treatment cost is reasonable and the risk of having to replace the joint again in the future is minimized.

Source: https://baodautu.vn/tin-moi-y-te-ngay-157-hy-vong-song-cho-benh-nhan-ung-thu-giai-doan-muon-d331225.html