—— Senior interventionalists fighting in the front line of clinical awareness of complications of interventional therapy Interventional therapy is minimally invasive surgical treatment of diseases under the guidance of imaging. As the third major clinical treatment discipline emerging after medical therapeutics and surgical therapeutics, it has become a first-line clinical treatment method because of its advantages such as small trauma, clear efficacy and quick recovery, which is popular among patients and doctors. With the promotion and popularity of this technology in the clinic, the complications (risks) of the treatment are on the rise and should be highly valued by physicians and patients. The risks of interventional treatment are ubiquitous. As one of the largest interventional treatment centers for bone and joint diseases in China, our department completes nearly 1,000 cases of various bone and joint interventional procedures every year, and various complications occur every year. , coma, hemorrhage, fracture, peripheral large nerve injury, pneumothorax, intestinal perforation, etc., with an incidence of 0.5% , 3, mild complications include allergic reaction, hematoma, infection, peripheral small nerve injury, skin burns, etc., with an incidence of 0.8%. Why are the complications of interventional procedures in large hospitals higher than those in small hospitals? With reference to the scale of hospitals at home and abroad, our hospital, as one of the large tertiary general hospitals in China, theoretically, it is reasonable to say that large hospitals should have less complications than small hospitals because of their good equipment and high skills of doctors. Large hospitals have a “concentration effect”, including two aspects, on the one hand, foreign patients to Shanghai concentration, on the other hand is a large hospital general specialist patients to another large hospital strong specialist concentration. In other words, most of the patients treated in large hospitals are patients screened by small hospitals or general specialties of large hospitals, and most of the patients who are easy to do and less risky are treated in small hospitals, while patients who are difficult and risky are pushed to large hospitals, and it is the responsibility of large hospitals to solve difficult cases. It is easy to understand. In my department, for example, many patients come from other provinces and cities with difficult cases and travel thousands of miles to our hospital for treatment, so with such a large concentration of high-risk patients, the responsibility and risk on doctors can be imagined. Some people wonder how interventional surgery can have such a high risk of complications when it is a minimally invasive procedure. Objectively speaking, patients are significantly less traumatized during interventional procedures than during traditional surgical procedures, but less trauma is not the same as less risk. So where do the risks of interventions come from? First of all, surgical injury is an objective risk. Surgery is a double-edged sword, which both cures and hurts, and the surgical procedure is inevitably accompanied by damage to normal tissues, with serious complications occurring after injury to important organs and tissues, moderate complications occurring after injury to less important organs and tissues, and mild complications occurring after injury to unimportant organs and tissues. Secondly, the patient’s underlying diseases and poor physiological conditions are high risk factors for the occurrence of risk, including advanced age, advanced tumors, cardiac and cerebrovascular diseases and visceral insufficiency. Finally, the risk of economic loss should be considered. Some of the high-value devices are self-financed, and if they are effective, it is considered an investment in life with benefits, and the psychology can still be balanced; if they are not effective, the hard-earned money will be wasted, and coupled with complications, it may end up in a “financial failure”. Interventional surgeons and patients must clearly understand that there are risks associated with interventional treatment. The doctor must inform the patient of the procedure and the purpose of the treatment before the procedure, and must also fully inform the patient of the risks. The sober patient has the right to choose the treatment plan, the right to be informed and the right to avoid risks, there are multiple treatment methods for a disease, each method has its own advantages and disadvantages and risks of different sizes. When the risk occurs, the body will be damaged to different degrees, and in serious cases, paralysis or even life threatening. Both the doctor and the patient fear the risk, but they also have to be brave enough to face it. When a disease is detected or progresses to a certain level, interventional treatment is needed to relieve the pain of the disease at the moment and to resolve or reduce the potential for greater risk, and the patient must face new risks associated with the procedure itself. When the patient chooses treatment, the risk is that the patient may not be cured of the original disease, but will have to endure new pains such as disability due to complications, and suffer both physically and mentally. When a doctor chooses to treat a patient, the risk is that his or her reputation, which has been earned over half a lifetime, may be ruined, and he or she may have to endure medical disturbances from irrational family members, malicious claims, threats to the doctor’s future, interference with the working environment, and even personal attacks, as well as pressure from the leadership and management, and in serious cases, suspension, and the family will have to drink the northwest wind. Accordingly, we can summarize a warning to both doctors and patients, please remember, “treatment has risks, choose carefully. Although doctors and patients are afraid of the risk, but the risk is still waiting for us in the near future, the government, society is not yet able to carry and resolve the risk, the risk is only the doctor and the patient to share, is it rational to face together, or to protect themselves, or to avoid? Doctors and patients have to think and decide carefully! Interventional therapy is not a panacea. Interventional therapy is one of the many treatment methods in contemporary medicine, and it is not a panacea for all diseases. For example, interventional treatment for advanced tumors is only a kind of palliative treatment to control tumor growth to a certain extent. If the tumor is stable or shrinking, it means that the interventional treatment is effective, and if the tumor is increasing or spreading, it means that the interventional treatment is ineffective. The effective cases can continue the interventional treatment, while the invalid cases should be replaced by other effective treatment methods in time. The invalid tumor treatment cannot be blamed on the doctor, let alone instigated by people with bad intentions and adopt medical disturbance against their conscience. I often hear some patients say to me, “You cured my colleague’s (neighbor, friend, patient ——-) disease, you must be able to cure my disease too”. “You are a famous and authoritative expert in something, you can definitely help me to relieve my pain”. When I encounter this group of hopeful and highly expectant patients, I really have to be very apprehensive and spend my days in fear. First of all, I am just an ordinary professional doctor, not as calm and magical as the legend; moreover, my treatment method is used by many doctors, there is no secret magic weapon or miracle drug. Please do not believe in rumors and choose blindly, and do not harbor suspicion and hostility, please believe in sincere dialogue and frank communication between you and me, I will put my limited learning and skills in front of you for your prudent choice, and I serve you with my heart! I also dream that each exhausting working day will bring nights when you can sleep peacefully! The disease is at risk of paralysis without treatment, and the complications of treatment may also be paralyzing, how to choose ？？？？？？ The disease is developing and there is always the threat of paralysis and death. The patient and his family weighed their options and chose interventional treatment and were willing to take the risk of surgery before the doctor dared to let go and the surgery was successful and the disease was effectively controlled. If the patient was unwilling to take the risk, the doctor would not have dared to operate.