Vinmec saves the life of a patient with late-stage esophageal cancer

Twice with cancer, disease on disease

Mr. NXT (born in 1970, Hanoi ) had vocal cord cancer and had a partial vocal cord resection 8 years ago. In March 2024, the patient once again faced esophageal cancer in the upper-middle third.

When discovered, the tumor was in the late stage, large in size, invading surrounding structures and had lymph node metastasis. At the same time, the patient had high blood pressure and diabetes for many years.

Coming to Vinmec Times City International General Hospital (Hanoi) in a complicated condition, the patient was prescribed chemotherapy and radiotherapy by the hospital's Oncology Board (MTB) and at the same time, the tumor was completely eradicated. However, the tumor did not respond completely, so surgery became the only option to save the patient's life.

“ On the PET CT scan, only the core of the tumor has absorbed the drug, proving that the tumor has responded quite well to chemotherapy and radiotherapy. This means that the tumor is not as large as observed on the CT scan. Therefore, the patient is still able to undergo surgery, although it is very difficult. We have proposed endoscopic surgery to remove the tumor with a team with a lot of experience in radical surgery,” said Associate Professor, Dr. Pham Duc Huan, Director of the Center for Digestive - Hepatobiliary - Urology and Co-Chairman of the Oncology Council.

Multidisciplinary doctors work together to find a treatment plan for the patient.

According to Associate Professor, Dr. Pham Duc Huan, this was a difficult decision because the tumor after radical chemotherapy and radiotherapy was stuck to many important structures such as the heart, bronchi and thoracic aorta. Surgeons are required to have high professional qualifications and precise dissection skills to ensure patient safety.

Another major challenge in the surgery was the problem of tracheal stenosis, a legacy of the patient's vocal cord surgery 8 years earlier. The diameter of the trachea at the narrowed site was only about 6mm, half the normal size, making intubation difficult and at risk of failure.

“ Vinmec doctors agreed to prepare 3 anesthesia options, in which placing a small endotracheal tube is the top priority, 2 backup options are tracheostomy and using the artificial heart-lung system (ECMO). All resources and equipment are ready in the operating room to handle situations, ” said Dr. Vu Tuan Viet, Head of the Anesthesia and Pain Relief Department.

During the 8-hour surgery, the team completely removed the tumor and created a new esophagus behind the sternum, ensuring swallowing function and maintaining the patient's quality of life.

After the surgery, the patient quickly recovered thanks to the application of advanced pain relief methods and ERAS (early and painless recovery after surgery) post-operative care. After only 7 days, the patient was discharged from the hospital, earlier than the usual period of 10 - 15 days.

Just 1 day after surgery, the patient can move comfortably and is discharged after a week.

Breakthrough in endoscopic surgery for digestive cancer

Esophageal cancer surgery, esophagoplasty using stomach or colon is still considered the most difficult gastrointestinal surgery technique in digestive surgery. To achieve the level of radical removal, removing maximum cancerous tissue for the patient, the common esophageal surgery method in many hospitals around the world is still open surgery.

At Vinmec, more than 95% of gastrointestinal cancer surgeries are currently performed by endoscopic methods. This number is due to the team of highly specialized doctors. Among them, Associate Professor, Dr. Pham Duc Huan, Director of the Center for Digestive - Hepatobiliary - Urology, is known as one of the two pioneering surgeons in Vietnam performing endoscopic surgery to treat esophageal cancer. To date, he has performed thousands of surgeries, prolonging the lives of cancer patients from 10-20 years after treatment.

Vinmec Healthcare System in general and Vinmec Times City International General Hospital in particular always update the latest cancer treatment guidelines from the US and Japan... ensuring the application of advanced medical advances. Surgeries are performed with modern pain relief methods, especially without using morphine, combined with care according to the early recovery after surgery (ERAS) model, helping patients recover quickly and return to normal life.

Ha An

Source: https://vtcnews.vn/vinmec-cuu-song-benh-nhan-ung-thu-thuc-quan-giai-doan-muon-ar913968.html