Bring blood out of the body for the first time to manage gas

Diem Thuy 19 years old, with tracheal stenosis, doctors use ECMO system to transport blood outside the body during surgery to open the airway.

Diem Thuy used to have tuberculosis, after treatment left complications of stenosis. The girl entered Cho Ray Hospital in November 2019 in a state of difficulty breathing.

Associate Professor Vu Huu Vinh, Head of Department of Thoracic Surgery, Cho Ray Hospital, said: "Scarring due to tuberculosis on the trachea is very rare, international literature only reports individual cases".

10 years ago, doctors from Cho Ray Hospital helplessly witnessed a 21-year-old girl with stenosis due to tuberculosis, died because at that time there was no effective treatment. Some places apply the technique of casting, stenting, but not much improvement.

According to Dr. Vinh, up to now, the hospital has operated about 75 narrow sections to treat gas-bronchial stenosis due to many causes such as trauma, complications after endotracheal intubation, due to ingestion of chemicals, acids ... Particularly narrow due to the tuberculosis trachea can not be dissect surgery because TB germs stick along the trachea, causing wide, long, complicated lesions.

"Initially, the doctors were quite hesitant, but with the determination of the family and the patient, the operating team focused on finding a plan," said associate professor Vinh. Dr. Vinh has a lot of experience in tracheal surgery, because he was a pioneer in applying the technique of sliding, tracheal transplantation in about 60 children with congenital stenosis in Vietnam.

Because children's airways are short and cannot be disconnected, children with this disease have to wait for death for a long time. With sliding technique, the doctor cuts along the two sides of the trachea, then overlaps each other, helping the airway, although shorter, is good, without cutting any sections. "This TB patient can apply the same mechanism", Dr. Vinh shared.

Doctor Huynh Quang Dai, Emergency Resuscitation Department, Cho Ray Hospital, said that in order to manipulate the airways, he used to use the help of an artificial heart-lung machine during the operation. Currently, with the development of ECMO technology, oxygen exchange across the body membrane, the patient will be safe, avoiding complications better. During the operation the patient is not breathing through the lungs but breathing through the ECMO machine.

On December 18, Diem Thuy underwent surgery with the coordination between sliding technique and ECMO. After 5 hours of operation, the patient's airway is normally good.

On January 7, the patient's trachea performed well as a normal person. Thuy is in difficult circumstances. Most of her surgery costs are supported by the hospital mobilizing donors.