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The First Case of Resection of a Huge Buccal Mass Performed in Shannan, Tibet by Tibet-aiding Doctors of Our Hospital

39Admin2018-11-21from:Hunan Cancer Hospital

Inthe morning of November 19, 2018, in the surgical ward of Shannan Tibetan Medicine Hospital, Tian Hao, a Tibet-aiding doctor andan associate chief doctor of Head and Neck Surgery DepartmentII of Hunan Cancer Hospital, came to the patient Qu Zong on the bed 21. Knowing that the patient felt good after eating orally for three days and retest results of related indicators were all normal, Doctor Tian Hao carefully examined the wound inside the patient's mouth again and told him he could be discharged on the same day. Qu Zong, 65 years old, smiled happily. Though having language barrier, honest Qu Zong kept nodding his head to expresshisthanks with palms together.

Thirty years ago, Qu Zong noticeda mass about the size of a chestnut in the left buccal region, which recurred shortly after resection at a local hospital. In recent years, the mass grew rapidly to the size of a fist, seriously affecting appearance, accompanied with local pain, and has not been cured in many hospitals all over Tibet. Half a month ago, with a great hope, the patient came to the department of surgery of Shannan Tibetan Medicine Hospital for treatment, after his relatives learned that the head and neck tumor surgery can be performed here at present. After a detailed inquiry and physical examination, Doctor Tian Hao, now the deputy director of the Department of Surgery oftheTibetan Medicine Hospital, told the patient that he could be admitted for surgery though the conditions was complicated. Hearing that, the patient and his relatives were all very happy.

Director of the Department of Surgery of Tibetan Medicine Hospital,BasangWangdui said“the department will try its best to cooperate with teacher Tianin his work, and we all expect to learn more related knowledge and skills through this case.”After completing related examinations, Tian Hao invited Huang Bin,the associate chief doctor of the department of radiology,et al. to participate in the consultation to discuss this case. Under the auspices of Director Basang, the experts performed detailed analysis and teaching through this case in the aspects of case writing, medical history report, physical examination details and relatedexaminations. Based on the opinions from the discussion, Deputy Director Tian Hao finally summarized that: 1: "left-sided buccal glandular giant tumor" should be considered; it is about6X5cm and can be radically resected; 2: instead of the approach via a facial skin incision used in the first surgery, the intra-oral approach through the buccal mucosa should be adopted this time, which can not only minimize trauma and risk, but also effectively avoid further affecting the appearance; 3: the method of general anesthesia with trans-nasal intubation should be adopted in cooperationwith surgical exposure and operation.

Inthe morning of November 9, 2018, after nasally intubated by an anesthesiologist, the patient received the “trans-oral buccal mass resection” performed by the associate chief doctor Tian Hao successfully according to the plan in less than an hour. All doctors in the surgical ward observed the operation in the operating room.Doctor Tian Hao did not forget to perform analytical teaching while operating on the patient, and everyone admired the teachers for their accurate selection of the surgical approach and adept operating skills.

After the operation, having no time to change his clothes, Tian Hao immediately organized all doctors of the department to discuss and study the case again, comprehensively retrospectingand summarizing the entirediagnosis andtreatment process of the case, including medical history collection, specialistphysical examination, related reading, preoperative preparation, surgical operation and postoperative care, etc. Director Basang highly praised the Tibet-aiding experts for their performance: "in the last few months, teacher Tian has provided comprehensive mentoring and help for the students of the TibetanMedicine Hospital throughteaching rounds, special lectures, surgical demonstration and paper writing directionand other methods. Without any understanding of head and neck tumorsat the very beginning, the students now have a certain understanding of and are strongly interested in i;instead of studying passively at the very beginning, they all now can actively take images in different stagesduring the process of operation. I believe that in the near future, the doctors of the department, trained by the teachers, will really be able to relieve sufferings of the patients with head and neck tumor in Shannan."

As a member of the first group of Tibet-aiding team of the Organization Departmentof the CPC Central Committee, Doctor TianHaois mainly responsible for helping Shannan Tibetan Medicine Hospital carry out related operationsofhead and neck surgery. Since entering Tibet in March this year, 8 cases of operations have filled the gaps in the TibetanMedicineHospital;5 cases have filled the gap in Shannan City and 2 cases werethe first in Tibet Autonomous Region.

In the national microscopic technique training class sponsored by our hospital in May this year, with the full support of Secretary Zhou Xiao,Director Yu Jianjun and Li Zan, Doctor Tian Hao was not only mainly responsible for the training of head and neck group, but also brought the Tibetan student doctor ZhaxiPingcuo here. Doctor Zhaxi learned a great deal from two weeks of study. After coming back to Tibet, he reported the detailed information about this study to the leaders of the Tibetan MedicineHospital, and the relevant leaders of the Tibetan MedicineHospital repeatedly said that they still hope to get a place in next year's study class, and send doctors to the department of surgery of our hospital for a long-term learning.

Doctor Tian Hao said "Since the Tibet-aiding work began, though the environmental impacts cause us some discomfort, it makes us feel all warm that in just a few months, President Liu Xiangguo and Vice President Hu Jun, respectively heading several leaders, came to Shannan to visitus, sincerely caring about our work and living conditions in a strange land. Great thanks for the support of the hospital, we will never forget our initial determination, and strive to actually do more for the Tibetan people, contributing to the friendship between the Tibetans and Hans, and winning glory for our Hunan Cancer Hospital!" 

(patient appearance)

(preoperative discussion)

(surgical scene)

(postoperative summary)

(teaching rounds)

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