Affiliated First People’s Hospital Uses High-Intensity Focused Ultrasound Ablation for a Complex Prostate Cancer Case for the First Time
Recently, the Urology Center of the First People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine used high-intensity ultrasound ablation (HIFU) for the first time to complete an operation on a complex prostate cancer patient with extremely high surgical risks, opening up a new path for surgical treatment of similar patients.
The patient, Mr. Lu, came to the Prostate Department of the Urology Center of the Affiliated First People's Hospital because of difficulty urinating. After careful evaluation, he was diagnosed with early-stage prostate cancer and could be treated with surgery. However, after a further examination, the medical team discovered that Mr. Lu had had a vascular stent inserted due to thrombosis in his lower limbs a few years ago, and new thrombi were attached to the stent. If a blood clot breaks off during surgery, it could be life-threatening.
Surgery carried extremely high risks, yet without it the cancer would be difficult to eradicate. This dilemma confronted Mr. Lu and the team led by Professor Han Bangmin, director of the Urology Center. Han Bangmin and Jing Yifeng, deputy director of the Urology Center and director of Prostate Surgery (North), convened an MDT discussion involving 13 disciplines, including vascular surgery, general surgery and radiology. After careful consideration, taking into account the assessment of Meng Qingyou, director of Vascular Surgery (North), the medical team decided to treat Mr. Lu’s prostate cancer with high-intensity focused ultrasound ablation (HIFU).
HIFU treatment is a non-invasive treatment for prostate cancer that uses high-energy ultrasound waves to focus heat into the prostate tissue, causing the cancer cells to rise in temperature and eventually die. Compared with traditional surgery, high-energy ultrasound ablation is non-invasive, less invasive, fast recovery, repeatable, and highly accurate, and is especially suitable for elderly and high-risk patients. In addition, HIFU treatment can avoid damaging surrounding normal tissues, especially key structures such as the bladder neck, neurovascular bundles, and urethral sphincter, and protect the patient's urinary control ability and sexual function to the greatest extent while ablating cancer lesions.
The surgical method has been determined, and the next step is to formulate a specific plan. Even with HIFU treatment, there are still many challenges in the patient's surgery. Because the patient is in a hypercoagulable state for a long time, new thrombi may appear during the operation. Due to changes in hemodynamics during the operation, the thrombus may fall off at any time. The medical team formulated a complete plan and conducted multiple simulation drills to strive to complete the operation safely and efficiently.
On the day of the operation, the chief surgeon, Cui Di, relied on his excellent skills to accurately control the ultrasound equipment to ensure that each beam of ultrasound energy could act on the tumor tissue accurately. Deputy Chief Physician Zou Yun of the Department of Anesthesiology closely monitors the patient's vital signs to ensure the safety of the operation. As the operation progressed, signs of successful ablation of tumor tissue gradually appeared on the ultrasound screen, and the operation ended successfully.
Four hours after the operation, Mr. Lu could drink water and get out of bed normally the next day. All indicators quickly returned to normal. The medical team carefully assessed his recovery and formulated a detailed rehabilitation plan, and Mr. Lu was successfully discharged from the hospital.