Surgery Godfather
Chapter 1508 - 1124: Blessings and Misfortunes Intertwined

Chapter 1508: Chapter 1124: Blessings and Misfortunes Intertwined

The number of volunteers for the Phase I clinical trial is temporarily insufficient, but Sisi’s treatment is not restricted by the Phase I clinical trial and can start ahead of schedule.

The biopharmaceutical factory of Ruixing is responsible for producing the biological agent. Their preparation technology is very mature, with both talent and equipment being very well-established. The prepared K biological agent is transported via cold chain vehicles and is very convenient to use, administered directly into Sisi’s body through intravenous injection.

After multiple improvements, the current type of virus-like microorganism is very safe, with no adverse reactions upon injection, resembling a common antibiotic injection. In rare cases, a low fever might occur, but this time Sisi didn’t even experience a low fever, making it as easy as injecting saline. This low reactivity is a result of many improvements made to the K virus.

During the process of improvement, the experimental team also discovered many patterns, making subsequent improvements more manageable. As data accumulated, the technical threshold became increasingly high, making it difficult for future followers to catch up.

This time, Sisi encountered no disturbances, and the entire process was very comfortable. Perhaps this was the best treatment experience she had since falling ill.

The lack of pain does not indicate the absence of treatment effects. Subsequent dynamic monitoring showed that this treatment was more effective than any previous ones, with imaging indicating a signal change in the original tumor images, presenting some diffuse edema signals. This signifies that the tumor cells are currently dying in large quantities.

However, the problem that follows is that the massive death of tumor cells causes cell membrane disintegration and cell fluid leakage, leading to tumor edema. Edema in other areas might not be a big issue, but if it occurs intracranially, especially in the brainstem, it is fatal.

If this continues, Sisi might develop brain herniation!

Everyone was on high alert. Yang Ping squinted slightly, staring at the dedicated electronic imaging screen, studying Sisi’s head MRI images, and fell into thought. This issue was considered before the experiment, but reality often differs from predictions. Initially, the therapeutic effect of the new K biological agent was underestimated, resulting in an excessive dosage, causing the tumor cells’ death rate to far exceed pre-experiment estimates. This is the root of the danger.

From the current situation, controlling the tumor cells’ death rate is also a technical key. Once it becomes uncontrollably fast, it could potentially lead to fatal brain herniation for intracranial tumors. To address the danger, Sisi was transferred to a dedicated ICU upstairs.

"The rate of edema increase is extremely fast. Look, it’s significantly worse today than yesterday. We don’t know where the peak and trough of the edema are, and without any experience to reference, we simply can’t know when it will start to subside. Should surgical intervention be considered? Professor Deng also reviewed Sisi’s MRI images, noting the rapid edema progression, but he also lacks experience in this area, as he has never seen edema caused by the rapid death of intracranial tumor cells and the inability to absorb cell debris, so he also cannot predict the edema curve." Song Zimo commented from the side.

Professor Deng, now a neurosurgery professor at the Institute’s outpatient, previously worked at Temple of Heaven Hospital and was later brought into Sanbo Hospital as a neurosurgery expert in their expert group. Despite his extensive experience, he is also powerless in the face of this new situation.

The Institute’s model of combining clinical and research is very effective. Without robust clinical support, volunteers participating in the experiment would have no recourse when facing such dangerous situations, having to rely solely on luck.

"I’ve been considering this issue too. If we surgically intervene early, it would be highly destructive, with the surgery carrying extremely high life risks. However, if we do not surgically intervene, once the edema continues exacerbating and causes medullary brain herniation, the success rate of surgery at that point would be very slim." Yang Ping rubbed his nose; this decision is extremely difficult to make.

No matter what is done, the risks are high. One option is active intervention, where the risk lies in the surgery, putting the risk in Yang Ping’s hands; another option is passively waiting, relying on luck, with uncontrollable factors at play, where the risk lies with what one could call luck. Perhaps now is the peak of the edema, and it’ll begin subsiding later, but it could also not be the peak, with the edema continuing to progress quickly, making survival nearly impossible.

One option utilizes subjective ingenuity, while the other relies on passive opportunism.

The current treatment is already in an out-of-control state. Yang Ping reviewed the images repeatedly: "Start with the first MRI image, play them one by one slowly."

The doctor controlling the computer immediately complied, pulling up the first head MRI image Sisi had taken at Sanbo Hospital, and from here, began playing all the head MRI images in the Sanbo Hospital database one by one in chronological order.

Yang Ping studied these images, analyzing them one by one, aiming to perform a longitudinal comparison and determine the current level of Sisi’s tumor edema based on these images.

The other laboratory researchers standing around, many of whom were not doctors, found themselves without any authority to speak, as the situation exceeded their knowledge scope. This illustrates the advantage of a composite team, which provides appropriate members to address any issues that arise.

Tang Shun and Lu Xiaolu kept their eyes on Yang Ping, awaiting his response. At this moment, Professor Yang is the most qualified person to make a decision.

The greatest risk for Sisi might be developing an occipital foramen herniation, also known as cerebellar tonsillar herniation. At this time, the cerebellar tonsil and medulla are being pushed towards the vertebral canal due to the pressure difference caused by edema through the foramen magnum. The medulla is a life center, and such compression of the medulla is lethal.

"Call Sisi’s parents over, I need to talk to them. Prepare for surgery, perform a craniotomy!" Yang Ping finally made the decision, choosing to take control of life into his own hands rather than leave it to uncertain luck. He doesn’t believe in luck, relying on it only when there are no other options.

A graduate student immediately ran to call Sisi’s parents, who had been waiting by Sisi’s ward. Sisi currently exhibits no severe intracranial nerve symptoms, but if the edema crosses the critical line, the mortality rate is extremely high.

"Sisi’s current edema has not yet reached its peak. The acceleration in the progression will be faster in the coming period. If no interventions are made, a severe, fatal occipital foramen herniation might occur tonight." Yang Ping predicted.

’’How should the surgery be done? Early bone flap decompression?" Song Zimo asked.

"Yes, that’s right, it’s the only way. Use bone flap removal to enlarge the foramen magnum, leaving sufficient space for the medulla. Immediately have Ruixing utilize 3D printing technology to print a set of scaffolds and an exterior shell from the cervical vertebrae to the occipital bone, which will be used post-surgery for temporary support and protection. This scaffold is critically important."

"I will immediately transmit the imaging data to Ruixing." The resident doctor Dr. Li responded right away.

Ruixing now has a flexible assembly line capable of customizing orthopedic internal fixation at any time, utilizing the most advanced 3D printing technology. They can complete the design, production, sterilization, and packaging of a set of internal fixation in two hours, ready for use on the operating table.