Chinese medicine: from rural hospitals to top three hospitals in Kyoto

The news that Chen Yang resolutely took on the "ghost" case soon reached Tokyo Metropolitan Central Hospital.

When Ono Shinji learned that Chen Yang agreed, he was stunned for a moment.

"It seems that Dr. Chen is really a man of great skill and courage." Shinji Ono said with a smile.

"With such a disease, even Mayo Clinic and Cleveland Clinic would not dare to take it over. Chen Yang is indeed very brave." The vice president echoed.

"Since Dr. Chen is willing to take over, then invite Dr. Chen to come." Shinji Ono was already a little impatient.

When Chen Yang and others arrived at Tokyo Metropolitan Central Hospital, Shinji Ono personally brought a large group of experts from the hospital to greet them at the door.

At Tokyo Metropolitan Central Hospital, the largest international conference room was temporarily transformed into a combat command center filled with a tense atmosphere.

Chen Yang and others followed Ono Shinji into the conference room. The two groups sat on both sides of the long conference table, appearing to be clearly separated.

From Country R, ​​almost all the top experts in related fields from major hospitals were present, led by Shinji Ono, the director of Tokyo Metropolitan Central Hospital, including the authority on cardiac surgery Shoichi Sakata, neurosurgeon Ryosuke Ishii, etc. The lineup was luxurious and could be said to be half of Country R's medical community.

On the Chinese side, it is naturally the core team of Kyoto International Medical Center led by Chen Yang.

On the huge screen in front of the conference room, shocking images of Ayako Ishikawa's blood vessels, which looked like they were wrapped with countless poisonous snakes, continued to be displayed.

Shinji Ono, a middle-aged man with meticulously combed hair, gold-rimmed glasses, and a serious and rigid expression, spoke first, his tone full of formulaic politeness and hidden deep scrutiny.

"Dr. Chen Yang, and all my Chinese colleagues who have come from afar, on behalf of the hospital and the Medical Association, I would like to thank you very much for taking the time out of your busy schedule to participate in Ms. Ishikawa Ayako's emergency consultation."

"I'm sure you all have a deep understanding of the complexity and severity of this patient's condition after reviewing the information. Its difficulty and extremely high risk are beyond words. I wonder what insights or initial ideas your team has offered after studying this?"

In an instant, everyone's attention was focused on Chen Yang, who was sitting at the head of the Chinese team.

Chen Yang slowly stood up and walked steadily to the front of the screen. Against the backdrop of the huge and strange image of blood vessels, his figure appeared unusually tall and steady, like an unshakable mountain.

"President Ono, all the experts present."

Chen Yang spoke slowly, his voice clear and steady, with a convincing power.

"The patient's condition is truly one of the most complex and challenging cases I have ever seen in my medical career. It can be described as a miracle on the brink of death. Traditional single surgical or interventional treatments, as you all know and have practiced, are extremely risky, have a slim success rate, and are almost unfeasible."

A trace of imperceptible disappointment and an expression of "as expected" flashed across Ono Shinji's eyes behind his glasses. It seemed that this Chinese genius, who was said to be so miraculous, was finally helpless in the face of a real terminal illness.

However, just when some experts from Country R were about to smile slightly, Chen Yang suddenly changed the subject.

"However, this does not mean that we can only sit back and watch lives wither away!"

Chen Yang picked up the laser pointer, and a striking red dot landed precisely on several key locations on the screen. "I believe that to overcome this dilemma, we must be bold enough to break away from conventional thinking, stepping outside the traditional diagnostic and treatment framework, and adopt a radically new treatment strategy we can call 'staging, zoning, hybridization, and integration.'"

"Stage zoning? Hybridization?"

There was an immediate burst of suppressed whispers from the audience, and many experts frowned, obviously confused and even skeptical about this unfamiliar combination concept.

"Dr. Chen, please explain the mystery in detail." Professor Masakazu Sakata leaned forward, his face showing great interest and concentration. He keenly felt that this young man might come up with something truly remarkable.

“First, it’s staging and zoning.”

The laser pen in Chen Yang's hand was like a scalpel, slashing across several of the most dangerous and prominent aneurysms.

"We cannot and must not try to solve all problems in a single treatment. That is an unrealistic fantasy and will only put patients in greater danger."

"We must scientifically and accurately stratify the risk based on the immediate risk of aneurysm rupture and the impact of malformed blood vessels on the functions of vital organs such as the heart, brain, liver, and kidneys. We must concentrate our resources and prioritize the most critical and urgent lesions, just like bomb disposal experts who always cut the most critical fuse first when defusing a bomb."

"for example,"

The red dot of the laser pen in Chen Yang's hand was firmly locked on the huge thoracic aortic aneurysm.

"This giant aneurysm, located in the thoracic aorta, is over seven centimeters in diameter. Its walls are as thin as a cicada's wing. It is hanging over the patient's head. It is the first, largest, and most dangerous bomb that we must defused."

"So, how does Dr. Chen plan to defuse this bomb?"

Shinji Ono couldn't help but ask, his tone tinged with doubt: "Use traditional open-chest aneurysm resection and artificial blood vessel replacement? With all due respect, given the patient's current cardiopulmonary function and overall condition, she probably wouldn't be able to withstand such a massive surgical trauma and the stress of extracorporeal circulation."

"This is the core of my second point, hybrid surgery."

Chen Yang said slowly, "We're not performing this in a traditional large operating room, nor in a simple interventional catheterization room. We need a 'hybrid operating room' that can perform both open surgery and full-time real-time interventional treatment."

Chen Yang explained in detail: "For this thoracic aortic aneurysm, I recommend a modified hybrid approach of 'aortic arch replacement plus elephant trunk stent implantation'."

"The specific steps are: first, a median sternotomy is performed. With the assistance of extracorporeal circulation, the diseased aortic arch is carefully freed and removed, and then precisely replaced with a pre-measured polymer artificial blood vessel."

"Then, through the newly replaced artificial blood vessel, a new channel is used to implant a specially designed covered stent, often called an 'elephant trunk stent,' into the true lumen of the distal descending aorta. This is used to cover and isolate any aneurysms, stenosis, or ulcers that may exist in the descending aorta."

"The advantage of this improved hybridization scheme is that,"

Chen Yang paused briefly, then concluded, "This approach not only eradicates the aortic arch, the most dangerous 'burst point', through relatively controlled open surgery, but also uses minimally invasive interventional procedures to reinforce and extend the treatment range with stents, avoiding further dissection and trauma, and significantly reducing the overall risk of the surgery."

"At the same time, this successful replacement and stent implantation is like establishing a solid 'bridgehead' on the battlefield, laying a stable anatomical foundation and operating platform for subsequent staged treatment of other problems such as the thoracic and abdominal aorta."