Guihuai Wang of Tsinghua Changgeng Hospital unveils the mystery of spinal tumors

Guihuai Wang of Tsinghua Changgeng Hospital unveils the mystery of spinal tumors

Guihuai Wang of Tsinghua Changgeng Hospital unveils the mystery of spinal tumors

The invisible and mysterious discipline-neurosurgery

In 1997, the Chinese Academy of Neurosurgeon Taiduo Wangzhong, a 21-year-old patient was removed of a 22cm long ependymal tumor from the medulla oblongata to the thoracic spine. At that time, it could be regarded as a technological creation and was once praised by foreign experts as " A century work that shocked the world. " In 2005, Professor Wang Guihuai, a student of Academician Wang Zhongcheng, fought for 14 hours to remove a 26 cm long ependymal tumor from the medulla oblongata to the sixth thoracic pulp. No one has surpassed it yet. Today we interviewed Wang Guihuai, director of neurosurgery from Tsinghua Chang Gung Hospital. As a proud disciple of Wang Zhonghuai, a member of the Chinese Academy of Engineering, he showed his understanding and talent to the teacher and the world during the operation 11 years ago. Since becoming a student of Academician Wang Zhongcheng in 1994, he has been with the teacher for 18 years. The group of "Science of Medicine" of the Central Radio and Television Network followed him into the discipline of neurosurgery to understand the mysterious spinal tumors. 

 

Wang Guihuai, Director of Neurosurgery, Tsinghua Chang Gung Hospital

The invisible and mysterious discipline-neurosurgery

　　Neurosurgery is roughly divided into three areas: brain, spinal cord, and peripheral nerves. These three parts make up what we call the nervous system.

　　Brain-craniocerebral, that is, the skull, the brain inside.

　　Spinal cord-Connected to the second skull is the spine and spinal cord. The brain and spinal cord are integrated into a whole. What we can feel from the back of the neck down to the waist is the spine, and the tissue that goes inside is called the spinal cord. We can see the spine, the brain and the spinal cord have very strong bone systems.

　　Peripheral nerve-The nerve that spins out laterally at each spinal stage, called the spinal nerve. The division of neurosurgery discipline is relatively fine. The craniocerebral part contains tumors, brain tumors, cerebrovascular diseases, cerebral hemorrhage, brain trauma, and functional diseases of the brain; spinal cord and spinal cord include trauma, tumors, and vascular diseases, and common cervical spondylosis, lumbar spondylosis and deformities; The third section relatively intersects many other disciplines, such as stab wounds and peripheral nerves. This is called peripheral neurology, which has a lot of overlap with another discipline, orthopedics. All nerves basically extend along muscle blood vessels or bones, and my limbs can move, and they are innervated by nerves.

　　These three aspects are the common areas for treating diseases in neurosurgery.

Tsinghua Chang Gung Hospital-Committed to neuroscience eye-care + medical

Guihuai Wang introduces neurosurgery to reporters

Tsinghua Chang Gung Hospital-Committed to neuroscience eye-care + medical

　In the national medical industry, Tsinghua Long March Hospital, which has only been established for two years, is undoubtedly a new team. Director Wang, as one of the earliest founders of neurosurgery in China, leads this young team to continuously study diseases of the craniocerebral, spinal and spinal cord, and peripheral nerves. Looking ahead 100 years from the next 50 years, they will become the veterans of the field.

　The development of medicine into the 21st century has brought about many revolutionary changes. In the future, big data, robotics, and intelligence will penetrate these areas. The field of neuroscience combined with advanced disciplines will be more precise and intelligent.

Precision-Nervous system surgery is challenging

　The nervous system governs the physiological functions of the human body. The brain, spinal cord, and even the nerves are the control system of the human body. All signals and commands from the brain are sent to the spinal cord, transmitted, and then transmitted to various parts of the body. If the disease occurs in the brain or spinal cord of the nervous system, it may not cause the patient's dysfunction, but if important nerve structures are injured during the operation, it will lead to paralysis and even death. 

　　For tumors of the spinal cord, there is a term in the neurosurgery community called restricted area surgery. Problems in the restricted area are fatal, with serious consequences. This is one of the main challenges in spinal tumor surgery. Every spinal tumor operation may cause paralysis of the patient or cause respiratory dysfunction. So the challenge of spinal tumor surgery is very high.

Psychology, immunity, environment and internal and external factors make tumors find you

　　There are many parts of the human body, various tissues and organs, and tumors may occur at any time. So far, the scientific community has not clearly defined the formation or texture of tumors. Generally speaking, tumors are abnormal growth and division of body cells. A person cannot grow from birth to a certain time, and the cells are stable. A tumor is a certain type of cell that secretes and grows continuously every day, and at the same time it must absorb the nutrients in normal tissues. The consequences can be imagined. Therefore, tumors are divided into benign and malignant types from the perspective of formation texture. The relative growth rate of benign tumors is slow, and they often grow in the original site. Malignant tumors grow rapidly, and they can grow in the same place, and can spread out of the place and spread to other parts through blood and lymph.

　　Although the scientific community has not fully understood the formation of tumors at present, there is a general conclusion that the formation of tumors is related to the genes in the cells. It is because the genes have changed the code that makes cell division problem. What causes the genes to change? There are various environmental factors, external environmental factors, nature, and natural light. Beyond that. There are also the effects of environmental factors in the human body. The factors that change the internal environment are very complex. A person's mentality, immunity, and spirit can cause changes in the internal environment. The internal and external environment interacts, causing our cells to change and produce tumors.

Struggle for 14 hours to remove 26 cm spinal ventricular meningioma

26 cm spinal ventricular meningiomas

　　Director Wang had a case of spinal ventricular meningioma removed in 2005. This ependymoma is inside the spinal cord. For example, there is a circle center in the center of the cylinder is the central tube. The cells inside the central tube are called ependymal tumor epithelial cells. The central tube in the center of the spinal cord extends from the neck to the waist. This long tube is usually closed. Tumors are formed when the cell compartment tubulomas are genetically altered.

　　Since the central tube of the spinal cord goes down to the brainstem and thoracolumbar, in such a long central tube, the ependymal tumor growth tumor sometimes becomes very long. If the tumor is only thick and thick, it is not terrible, but if it is long and thick, nerve compression will be very serious. The patient's tumor was 26 cm long, and it was conceivable that it was difficult to completely clean it.

　　The surgery uses microscopic techniques to protect the surrounding spinal cord and isolate the tumor completely. After the tumor is removed, the spinal cord is sutured, the bones outside the spinal cord are installed one by one, and the muscles are sutured at last. Surgery is complicated. The operation continued from the morning until the night. Fortunately, the tumor was cut very cleanly. Through postoperative rehabilitation, the patient's daily life can be treated, and a certain ability to work is restored.

Surgery is the best treatment for spinal tumors

Guihuai Wang is performing surgery on patients

　　Surgery is the best treatment for spinal tumors

　So far, the first choice for treating spinal tumors is undoubtedly surgery. What causes spinal tumors to be removed?

　　First of all, imagine that in the middle of the large ribs, if there is a tumor in the spinal canal with thick fingers, the drug cannot enter directly. Unlike lung cancer and breast cancer, chemotherapy drugs have little effect on spinal tumors.

　In the second aspect, X-rays are widely used in the field of radiotherapy, but if there is no surgery, the X-rays are directly injected into the spinal cord and into the tumor, and the tumor will be necrotic and edema. The space between the bones is limited. Once the peripheral spinal cord can't bear it, the patient is at risk of paralysis at any time.

　So whether it is a large tumor or a small tumor in the spinal cord, surgery is the best choice.

Explore new methods and improve old methods 

　Now that I have been working for 30 years, leaving the medical school for a full 30 years, being a good doctor has always been a core part of my original heart.

　After more than 20 years of clinical work, I realized that the connotation of doctors is not just about treating the sick and saving people, and optimistic about the patients. We have inherited and learned the experience summarized by our predecessors, but we have not solved many problems that our predecessors did not solve. This made me understand more deeply that doctors are not simply learning a skill and performing an operation, which can solve the patient's pain. This is the main content. In the process of treating diseases, we must continue to explore new methods and improve old methods.

　Doctors are not only treating patients and saving people, but they are also on a mission to explore the path of medical development.

　Why did I leave from Beijing Tiantan Hospital after 20 years of work and come to Tsinghua? Because Tsinghua's research conditions in medical and life science-related disciplines are second to none in China, I very much hope that in this field, it will be closely integrated with university basic disciplines and explore the texture of tumors, spinal blood vessels and other diseases. Applying new methods to this area of ​​research is my biggest pursuit at present.

Wang Guihuai, Director of Neurosurgery, Tsinghua Chang Gung Hospital