The patient's tumor is so small that it may not be visible on CT scan now or in a few weeks.

Even MRI requires Zhang Hao to put aside all other work and spend several hours searching desperately in the pineal gland area to find abnormalities.

If Xu Qiu hadn't reminded him and it was locked in a small area, Zhang Hao wouldn't have been able to find it.

At this time, we rely on comparison to determine whether it has worsened. First, the lesions are too small and no changes can be seen at all.

Second, Tao Changhan's neurological pathology has become more and more serious in the past few days, and it is hard to say whether he can survive three weeks of radiotherapy alone.

The most important point is that the patient's pineal brain tumor is located slightly above the tentorial edge of the cerebellum, which is very insensitive to radiotherapy and chemotherapy.

In short, there is no other option but surgery!

This also made Zhang Hao feel quite desperate.

The hand holding the phone felt a little cold.

He glanced at the computer.

In the group chat, Han Zhizhang, Wei An and others all expressed their opinions.

Everyone thinks that the risk of surgery is extremely high and there is no point in doing surgery. They can only give palliative treatment and try to do simple chemotherapy to see how the patient fares.

Some people also think that Chinese medicine prescriptions can be prescribed to see if they can save tumors that are so difficult to locate that surgery and chemotherapy are ineffective.

Based on Zhang Hao's clinical experience, he also believed that surgery was impossible.

However, Xu Qiu didn't think so.

His calm voice came from the phone and said: "Director Zhang, please prepare for a joint consultation with brain surgery, oncology, etc. in the afternoon."

"Joint consultation?"

Zhang Hao was stunned and shocked: "Doctor Xu, your plan is to use a knife?"

"If you don't move, will you let the patient wait for death?"

Zhang Hao's throat twitched twice.

He wanted to say, "If the knife is not used, the patient is waiting to die; but if the knife is used, the doctor kills the patient himself."

However, when facing Xu Qiu, he stopped talking and said instead: "Do you want to form an MDT (multi-disciplinary, multi-department) team?"

Pineal gland brain tumors are a serious matter that cannot be handled by a single doctor, or even by a single department.

Only a multidisciplinary team can adapt to the ever-changing and thrilling conditions of pineal brain tumor surgery.

"yes."

"Yes..." Zhang Hao was stunned.

Why can Xu Qiu answer such a difficult operation so easily?

This is a pineal gland brain tumor. Whether it is difficult or dangerous, it is much more difficult than the previous giant meningioma.

It is different from craniocerebral separation surgery.

The difficulty in craniocerebral separation surgery is to separate the brain tissue and establish two different brain nutrition systems.

The difficulty in resection of brain tumors in the pineal region lies in removing a tumor from an extremely deep and dangerous place.

If we really want to analyze it from a technical level, craniocerebral separation is naturally the most difficult problem;

But in terms of risk, pineal gland brain tumors are not far behind.

All in all, there are only a few leading medical oncology hospitals in the industry that can perform this surgery.

"Okay, I'll prepare for a joint consultation." Zhang Hao said.

He glanced at the group chat and found that Han Zhang and others were following him again.

Han Jinzhang: "I heard that Dr. Xu likes to challenge this kind of difficult surgery. If he does this pineal gland brain tumor, he will call me."

Wei An: "And me. Shake hands.jpg."

After Zhang Hao read it, he said: "Doctor Xu, there are two deputy directors from other hospitals who also want to come and observe the surgery. What are your opinions..."

"all come."

Xu Qiu's answer was still brief.

The more people come, the higher the weight, and the higher the success rate of his surgery.

Of course he couldn't let go of this opportunity.

…

At five o'clock in the afternoon, just before get off work, a temporary multi-disciplinary and multi-department joint consultation was held in the emergency department.

Among those attending the meeting was Jin Yucheng from brain surgery.

He is a rising star in the brain surgery department of Linhai No. 1 Hospital. After Xu Qiu established the brain surgery base, he quickly mastered the essentials and switched from neuroendoscopic surgery to the more sophisticated field of intracranial separation, thereby mastering a large number of brain surgeries.

High-precision surgical skills and techniques.

Now he is not inferior to Director Lin. He is a good surgeon and is in high demand.

In addition, the directors and deputy directors of the oncology department, imaging department, anesthesiology department, and vascular department were all present.

In addition to these family members, there are four or five people who came from the outer courtyard, such as Han Zhizhang, Wei An and others.

The joint consultation finally ended at 6:17.

Based on the pathological results, the consultation was initially diagnosed as medulloblastoma (who, grade IV, classic type).

After that, Xu Qiu proposed a more rigorous surgical plan.

A simple summary is poppen surgery for tumors in the third ventricle and pineal region.

There are two conventional approaches for pineal brain tumors.

The first is from the infratentorial supracerebellar approach, which is also the most common approach.

The second is the posterior interhemispheric fissure. There are relatively few drainage veins from here. As long as the operation is gentle, the possibility of tearing the veins is very small.

However, Xu Qiu chose a rare approach.

It passes through the occiput and enters the cerebellar tentorium to the third ventricle and pineal gland area.

This technique is more difficult and there are many things that need to be paid attention to.

For example, when it retracts the occipital lobe, it may damage the visual cortex.

When the tentorium is incised, the trochlear nerve in front may be damaged.

In addition, since no one knows what Tao Changhan's tumor looks like or its origin, the final direction of the lesion's displacement is also different.

If the tumor is covered by thickened arachnoid membrane, additional incision of the arachnoid membrane is required, and the large cerebral veins may be injured if not careful.

What is even more dangerous is that when the tumor is stripped and removed, the internal cerebral veins, basal veins, and many branches are intricately distributed. It can be said that one drop of the knife can detonate countless "landmines" that are enough to kill.

"Why did you choose this approach?"

In the conference room, whether it was Jin Yucheng, Zhang Hao, Han Cheng, Wei An and others, their expressions were very serious.

Xu Qiu gave an explanation:

“If the approach is from the cerebellum, the large cerebral veins will inevitably be blocked, affecting the surgical field and operating space.

As for the posterior interhemispheric fissure, the tumor is located lower. If this approach is used, although the risk is small, the surgical path will be lengthened, the patient's injury will be increased, and the operation time will be increased."

The former limits the performance of the surgeon, which is equivalent to limiting the upper limit of the surgical effect.

The latter reduces the risk of death, but will increase minor injuries during the operation. It can be regarded as performing the operation at the lower limit of "the patient does not die".

The chance of survival is very high, but whether you live well or not depends on fate.

Xu Qiu's choice of poppen surgery for tumors in the third ventricle and pineal gland area left all this behind and left the surgical results entirely to the personal ability of the surgeon!

If performed well, it means perfect resection and perfect recovery.
Chapter completed!