“If it wasn’t for the doctor who only had a relationship with me, I would like to know what it would be like, so I must find him!” Recently, Grandpa Zhao found the deputy director of the Department of Thoracic Surgery, First People’s Hospital of Hangzhou. The doctor, I want to trouble him to find a doctor. He said that if his daughter had met the doctor at that time, she suggested that she should go to the chest surgery examination. The big nodule in his daughter’s body is really going to happen now.
There are two nodules in the lungs due to fever.
Things have to start from six months ago. Uncle Zhao’s daughter, Zhao Rui (a pseudonym), 29 years old, has been working in a certain institution. Occupational comfort, stable work, and elegant working environment. Zhao Rui also loves this job very much, actively asks for progress, and maintains good habits in life. She does not drink alcohol, does not smoke, often participates in outdoor sports, and pays attention to physical health. However, in November 2016, Zhao Rui accidentally had a fever and went to the hospital for examination. The chest CT found two nodules in the right lower lung with beans. At that time, she was hospitalized for anti-inflammatory and drip for a week. After normal temperature, she was discharged from the hospital and went home. .
Because her health awareness is relatively strong, she has been worried about whether the two small nodules in the lungs will change. After three months, I went to the hospital in Hangzhou to review the chest CT again. Because there are more patients in the hospital, Zhao Rui was a little annoyed. When she passed the respiratory clinic, she saw a doctor empty. Zhao Rui held a try to ask: “Doctor, can you help me see the film?” A young male doctor said nothing. After the film was read, the two nodules looked like some problems. It is recommended to look for a chest surgeon.
In this way, under the advice of this doctor, Zhao Rui found Feng Xing, deputy chief physician of thoracic surgery. Feng Xing carefully read the film on the computer and said: “Although the size of the two nodules in the lungs has no obvious change, the shape of the nodules is like the clouds in the sky. If it is looming, it will change the ground nodules. It is very likely that Very early stage of lung cancer, it is recommended to be active surgical treatment.” Zhao Rui slightly thought deeply, although the heart is extremely heavy, but still carefully followed the advice of Dr. Feng, immediately decided to hospital for treatment.
Nodular resection confirmed to be “cancer”
After adequate preoperative examination and preparation, the doctor performed a thoracoscopic single operation under the operation of Zhao Rui. Because the large nodule is 9.0 mm, the small nodule is 4.2 mm, and it is at the very early stage of the lesion, the density is low, and it is difficult to distinguish it from normal lung tissue. How to successfully find such a small nodule during surgery is a careful consideration before surgery. . In order to accurately find two tiny nodules during surgery, Feng Xing draws on the domestic and foreign advanced experience, and uses the precise positioning of CT to place the positioning needle next to the two nodules.
The operation adopts the advanced thoracoscopic two-hole technique. Only a keyhole-sized incision is placed on the right chest wall of Zhao Rui to insert the thoracoscope, and a 3 cm-sized surgical incision is performed to complete the operation. With the help of the positioning needle, Feng Xing quickly found the diseased lung, and immediately removed the test, and the results confirmed that the two large nodules were cancer. Feng Xing completely removed the diseased lung according to the scheduled surgical plan and cleared the surrounding lymph nodes.
After the operation, Ms. Zhao recovered well and she has no discomfort in daily life and activities. The final biopsy report suggested that both nodules were in situ adenocarcinoma with microinfiltration, and there was no metastasis of surrounding lymph nodes, which proved to be very early stage lung cancer, and the effect was good. It has been discharged smoothly.
Seeing her daughter as safe as ever, Grandpa Zhao’s original heavy heart was also a lot easier. “Daughter has always been the apple of the family. It may be a bit unfortunate to get sick this time, but fortunately, I can meet two good doctors. If it is not their accurate analysis that allows the disease to be discovered very early, and then Dr. Feng Xing’s superb technology, this The consequences may be really unimaginable.”
In the end, together with Grandpa Zhao, we found the doctor he was looking for, Qi Minghao, deputy director of the Department of Respiratory Medicine. The author asked Yan Minghao, do you still remember such a patient? He smiled and said: “Really, so many patients I really don’t remember. As long as the patient is okay now. It should be!”
●The lung nodules may be lung cancer, but the lung nodules are lung cancer
Feng Xing, deputy director of the Department of Thoracic Surgery, First People’s Hospital of Hangzhou, said that with the wide application of chest CT, there are more and more patients with small nodules and ground glass in the outpatient clinic, and there is a trend of younger.
As a lung nodule of lung cancer, early detection and early treatment are important ways to find lung cancer. How to screen out many lung nodules that need timely treatment so as not to delay the disease, miss the opportunity, and not let those patients who are not serious, do not sit restless, which requires doctors to combine their clinical experience, chest CT The size, shape, density, growth rate and other aspects of the nodule are comprehensively judged.
Dr. Feng Xing said that if there is a nodule in the lungs of people over 50 years old, there are any risk factors in the past:
● Smoking ≥ 20 packs / year. It also includes those who used to smoke but who have stopped smoking for less than 15 years:
● Passive smokers:
● There is a history of occupational exposure (asbestos, plutonium, uranium, plutonium, etc.);
● Previous history of malignant tumors or family history of cancer:
● Chronic obstructive pulmonary disease (COPD), a history of diffuse pulmonary fibrosis. Feng Xing said: “This part of the population is a high-risk group of lung cancer, requiring regular physical examination and review, and closely observe changes in the size of the nodules.”
Feng Xing also pointed out that for those clear and smooth ground glass nodules (GGO) with a margin of less than 8 mm, there are consistent treatment specifications at home and abroad. Most of these nodules are precancerous lesions – atypical adenomatoid-like hyperplasia. Or early lung cancer – in situ adenocarcinoma or microinvasive adenocarcinoma, which has a tendency to grow slowly. The regular treatment of nodules changes the treatment strategy, so that the lesion is completely within the controllable range: Solid nodules above 8 mm should go to the hospital for a timely visit.
Many people often equate lung nodules with lung cancer and find themselves afraid of lung nodules. In fact, it is found that the lung nodules do not have to be over-stressed. Although a considerable part of lung cancer is characterized by nodules in the early stage, not the lung nodules must be lung cancer. Many benign diseases such as tuberculoma, hamartoma, inflammatory pseudotumor, hemangioma Carbonized lymph nodes can also be expressed as small nodules. The key is to comprehensively analyze the results of the patient’s age, past medical history, chest CT, and blood tests.
In the past, people talked about cancer discoloration, and thought that suffering from cancer has an incurable disease. The reason is that there is a conceptual backwardness and a delay in treatment. Now, with the advancement of medical technology, lung cancer has been able to achieve early detection, and accurate treatment has achieved satisfactory results. In particular, through the fog of small nodules in the lungs, it is possible to detect the early stage of lung cancer hidden in it and to perform precise surgical treatment. Lung cancer is completely hopeful to cure.