Recently, PUMCH discharged a patient who had become more than a patient to the hospital. A mother of three children with a giant leiomyoma, she was reborn at PUMCH.

Ms. Wu, 40 years old, comes from a remote rural area. In 2021, she noticed that her stomach began to grow larger and later developed persistent abdominal pain. Carrying a heavy burden in life and lacking medical knowledge, she struggled to cope, only to suffer deteriorating health. When she finally got to visit the local hospital, operation was beyond the capacity of the hospital as the cystic solid mass in her body was too huge.

Accompanied by her elderly father, Ms. Wu came to Wang Weibin, Deputy Director of the Department of General Surgery, out of admiration for his reputation. Ms. Wu’s abdomen bulged to 118cm in circumference, causing dyspnea which almost disabled her. Despite the all the sufferings, Ms. Wu had high hopes, strong belief and trust in the medical staff that she could always see in every corner of the hospital. After knowing her past history of abdominal surgery, Wang Weibin quickly arranged MDT consultation for pancreatic disease; Huo Li, Director of the Department of Nuclear Medicine, signed her up for PET-CT scan; Xue Huadan, Deputy Director of the Department of Radiology, provided her with 3D-printed images; Lyu Ke, Deputy Director of the Department of Diagnostic Ultrasound, arranged puncture biopsy as soon as possible.

To make a thorough surgical plan, the surgical team reported to the Department of General Surgery immediately and received full support from the department and its Director Zhang Taiping. Wang Weibin also sought advices from Academician Zhao Yupei, who said categorically: “We surgeons in PUMCH should in no way shy away from such difficult surgeries. Be very careful to minimize the bleeding and tissue damage!” Academician Zhao also gave guidance and tips on the key points during the operation. The MDT consultation proposed several challenges: the blood supply of Ms. Wu’s tumor was extremely rich and diversely rooted but with no trunk, which exclude the possibility of transcatheter embolotherapy. The portal vein and inferior vena cava, two largest vessels in the abdomen, were severely compressed, or even invaded by the tumor. In light of this, the team adopted a “three-pronged approach”: first, preoperative normovolemic hemodilution; second, intraoperative autologous blood transfusion; third, blood preparation by the Department of Transfusion.

On September 2, 2022, Wang Weibin, Chen Ge, and Hou Rui together performed the surgery of giant tumor resection for Ms. Wu, started with a Mercedes logo-shaped incision in the abdomen. The severe abdominal adhesions from previous surgery, the huge tumor which blocked the operation light and the vision of the surgeons, made it nearly impossible to dissect by surgical instruments. The surgeons could only feel and separate the tumor little by little by hands, which necessitates much patience and skill. The blood vessels, peritoneum and intestines were tightly wrapped around the tumor, which had long been compressed and would easily rupture. During the operation, the surgeons needed to do the dissection and the hemostasis at the same time. Deputy Chief Physician Zhang Yu of the Department of Anesthesiology stood by closely, always on the alert for the drastic fluctuations of hemodynamics. The operating room nurses Yao Jingjing and Yu Ying watched attentively and cooperated without a moment’s delay. Everybody did a good job. The team, with their composure and superb skills, overcame all the obstacles and finally completed the operation after eight hours.

The tumor ex-vivo surprised all the medical staff in the operation room, being more than 30cm long, 25cm wide and weighing more than 15kg.

Post-operative rehabilitation was also crucial. The Department of Intensive Care Unit took great care to quickly stabilize Ms. Wu’s vital signs and she was then transferred back to the general surgery ward. Her intestines, after long-term compression, two surgeries, and repeated adhesion lysis, had developed obstruction. Dr. Wang Zhiwei, Chief Physician of the Department of Radiology, helped Ms. Wu by implanting an intestinal stent and she gradually regained motility. Head nurse Guo Shuli gave her compression stockings to prevent thrombosis. The ward nurses made her a simple respiratory function exercise aid to help restore her heart and lung function.

On October 3, Ms. Wu made a full recovery and was discharged from the hospital. The journey to recovery was tough. But the patient and the medical staff trusted each other and never gave up. Eventually, they together created a miracle of life.

Reporter: Gan Dingzhu

Correspondent: Zhu Jinjin

Translator: Liu Haiyan

Editor: Hou Rui and Wang Yao