"Twenty years ago, I had a kidney transplant in a hospital, and you saved my life. I didn't expect that twenty years later, you would be the ones who 'defused' the rectal 'bomb' for me, so that I would not suffer. Torture..." In the gastrointestinal surgery ward of Shanghai First People's Hospital, Mr. Xu, a patient, could not conceal his gratitude.
Recently, the gastrointestinal surgery team of the General Surgery Center of the First Hospital of the City, in conjunction with the Urology Center, Department of Anesthesiology, and other multidisciplinary departments, successfully performed a robotic single-port radical resection of rectal cancer on a patient who suffered from rectal cancer 20 years after a kidney transplant. , the patient's transplanted kidney function was not affected after the operation, and he recovered smoothly and has been discharged from the hospital.
Mr. Xu is 65 years old and is an old patient in a city hospital. In 2003, he underwent a kidney transplant at a city's urology department due to end-stage renal disease and renal failure. Anti-rejection drugs were taken for a long time after the operation, and post-transplant follow-up health management was carried out regularly in the city.
Twenty years have passed in the blink of an eye. All indicators in the review are good, and daily life is no different from ordinary people. More than a month ago, Mr. Xu developed bloody stools. After the epidemic stabilized, he went to the hospital as soon as possible. After a colonoscopy, he found a cauliflower-like mass in the upper rectum, and he was considered to have rectal cancer.
“I felt a bit broken and conflicted at the time.” Mr. Xu recalled, “I was worried that I would not be able to perform surgery, and I was also worried that long-term use of immunosuppressive drugs would affect the safety of the surgery.” These issues became a huge burden on his mind.
With more than 20 years of trust in City No. 1 Hospital, Mr. Xu and his family came to the outpatient clinic of Professor Huang Chen, deputy director of the City No. 1 General Surgery Center and director of Gastrointestinal Surgery (North), looking for the last glimmer of hope.
After carefully questioning the condition and conducting a detailed physical examination, Huang Chen decided to use robotic single-port radical resection of rectal cancer for Mr. Xu.
"As a doctor, my top priority as a doctor is to perform radical tumor surgery without affecting the function of the patient's transplanted kidney, while ensuring the blood supply and healing of the anastomosis, so that the patient can be discharged smoothly." With patient explanations, Mr. Xu and his family were relieved and decided to be hospitalized for minimally invasive surgery.
After being admitted to the hospital, Director Huang Chen, attending physician Xiang Shijun, as well as experts such as Qin Yan, chief physician of the Kidney Transplantation Department of the Urology Center, Professor Li Jinbao, director of the anesthesiology department, conducted careful preoperative discussions on Mr. Xu’s condition and decided to use robotic surgery. Minimally invasive plan for rectal cancer surgery, and carefully formulated perioperative management measures to accurately regulate anti-rejection drugs.
On the day of the surgery, with the cooperation of multiple disciplines, Huang Chen spent one and a half hours to successfully complete the robotic single-port radical resection of rectal cancer, lymph node dissection and digestive tract reconstruction through only a small incision of about 4 cm around the navel.
Under the guidance of the concept of rapid recovery surgery, the surgical team also adopted a multi-modal analgesic program for patients before, during and after surgery, which greatly reduced patient pain and surgical stress. On the first day after the operation, Mr. Xu could drink water and get out of bed, which further prevented venous thrombosis of the lower limbs and lung infections , and promoted the recovery of gastrointestinal function and mental and psychological recovery.
From the anxiety and negativity a month ago, to the increased confidence after seeing the outpatient clinic for the first time, to the excitement and gratitude now after the surgery, Mr. Xu’s mood has been like a roller coaster. “Thank you very much to the team of the Municipal No. 1 Gastrointestinal Surgery Team. It is their professionalism and patience that give our patients a sense of security and trust.”
According to reports, after organ transplantation, due to the long-term immune transplant status, the risk of malignant tumors in organ transplant recipients is relatively common. The average number among the population is 2-4 times higher, so attention needs to be paid and physical examinations should be strengthened.
In addition, organ transplant patients who take immunosuppressive drugs for a long time have weak organ function and poor tissue healing, and are at increased risk of various complications during the perioperative period, especially gastrointestinal anastomotic leakage and anastomotic bleeding.
This time, a city's gastrointestinal surgery department innovatively applied robotic single-port rectal cancer surgery to patients with rectal malignant tumors after kidney transplantation. It not only continued the miracle of life of transplant patients, but also reflected the super minimally invasive surgical capabilities of the multidisciplinary team. and superb perioperative management skills.
Author: Li Chenyan Xiang Shijun
Editor: Li Chenyan
