Surgeon said cutting off the “nidus” was critical

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Báo Tuổi Trẻ English - 34 month(s) ago 6 readings

Surgeon said cutting off the “nidus” was critical

At the time of this report, well-known American surgeon McKay McKinnon, who successfully removed a 200-pound tumor for a woman in 2000 in an 18-hour operation that drew worldwide attention, is teaming up with local doctors for a massive surgery to remove Nguyen Duy Hai’s 90-kilogram tumor at HCMC’s France –Vietnam Hospital.

McKay McKinnon American surgeon McKay McKinnon (R) during a discussion with a Vietnamese colleague from Ho Chi Minh City Oncology Hospital about Nguyen Duy Hai's case in November, 2011 Photo: Truc Quynh

He said in an earlier interview with Tuoitrenews that it was critical for the team to pinpoint and take out the origin of the tumor, which will help save the poor man from the disease permanently.

Hai, 32, suffers from neurofibromatosis, a progressive disorder of the nervous system that causes disfiguring tumors to form on nerves throughout the body.

Over the years, the tumor has grown from the base of his spine, enveloping his back and wrapping around his thighs. It is tightly packed with blood vessels, so cutting chunks out of it would cause massive bleeding.

McKinnon said the base of Hai’s spine was where the “nidus” was, which was also a hyper vascular area and the oldest one that fed the whole giant tumor.

The tumor itself is not cancerous, he said, but its enormous size makes it a deadly parasite that has absorbed blood and nutrients from Hai’s body.

Surgeons will have to remove the nidus in order to cut off the source of blood and nutrients that have been feeding the tumor, otherwise removal of any other parts of the tumor cannot prevent it from growing back.

The doctor’s diagnosis described exactly what happened to Hai while he was still seeking a medical option before giving it all up some time ago.

A few years back, Hai had his right leg amputated at a local hospital in his home town Da Lat in an attempt to remove the then still small neurofibroma. But it grew back not long after that and developed into a huge 90-kilogram one that it is now.

The surgery is scheduled to last 12 hours and surgeons will have to locate each of the hundreds of blood vessels feeding the tumor and start where the tumor gets the most blood supply, Doctor McKinnon told Tuoitrenews.

However, accidentally severing any one of these could cause fatal bleeding that can threaten the patient’s life on the operation table.

An operation of this scale will also require careful monitoring of Hai’s already weakening heart by a team of experienced anesthesiologists who need to make sure the anesthetic will not cause it to fail.

For this reason, they have had to consider which position would keep the patient in the most stable condition for the anesthetic and have determined that it was when he sat upright.

During the long ordeal, a large quantity of blood and plasma has to be ready, as Dr. McKinnon had to use 28 units of blood and 30 units of plasma in a similar case for a female patient with a 70-kilogram tumor in Romania.

Even if the removal is successful, grave threats still await Hai after the surgery as his body then will be a large open wound, any infection of which can easily take away his life. He will then have to go through multiple skin reconstruction operations, or skin grafts, to close the wound in his back.

After that, Hai will have to be put under intensive care for weeks and undergo intensive physiotherapy for months before being able to resume his normal life.

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