2014-12-10 Henan Provincial People’s Hospital, Henan Provincial People’s Hospital, Department of Interventional Medicine, Liu Ruiqing Figure 1. After local anesthesia, a catheter was inserted into the hepatic artery through the femoral artery at the root of the thigh, and the incision was about the size of a cotton swab, and a hepatic arteriogram was performed to find the tumor and its responsible vessels. Figure 2. The “criminal vessel” of the tumor is hyper-selected with the catheter and slowly injected with a mixture of chemotherapy drug and iodinated oil emulsion or the latest embolic microspheres, the French “drug-carrying microspheres”. As we all know, China is a big country of hepatitis B, and the rate of hepatitis B virus carriers is nearly 10%, while liver cancer mostly develops on the basis of hepatitis B cirrhosis. At present, the number of liver cancer patients in China accounts for about 55% of the world, which has become a serious threat to health and life, and its danger should not be underestimated. Liver cancer often starts insidiously, and most of them are already in the middle and late stage when they feel discomfort in liver area, which misses the best time for surgical operation. Generally speaking, surgical resection or interventional surgery is recommended for early stage liver cancer, while interventional chemoembolization, surgery and biological therapy can be used for mid-stage cancer. At this time, the only way to control local tumor is minimally invasive interventional surgery. According to Dr. Cao Guang Shao of the Comprehensive Interventional Oncology Department of Henan Provincial People’s Hospital, “hepatic artery chemoembolization” does not require any incision, only a fine needle is used to puncture the femoral artery at the root of the thigh, the incision is about the size of a cotton swab, a catheter is introduced into the tumor vessel and a mixture of chemotherapy drug and embolic iodine oil emulsion is slowly injected, the concentration of chemotherapy drug is relatively high and is injected directly into the tumor. The concentration of chemotherapeutic agent is higher, and it is injected directly into the tumor to “poison” the cancer cells, and it is attached to the iodine oil beads and released slowly, which has a longer duration of action. In contrast, systemic chemotherapy dispenses chemotherapeutic agents into large bottles of liquid, which are less concentrated, and very little chemotherapeutic agent reaches the tumor after circulating throughout the body, but it has the advantage of killing potential cancer cells in the blood throughout the body. On the other hand, we “block” the branches of blood vessels that supply nutrition to tumors through catheters, and “starve” the tumors alive. The two-pronged approach of “poisoning” + “starvation” can better control the tumor lesions. This approach is suitable for benign and malignant tumors of all systems, such as hepatic hemangioma, uterine fibroids, lung cancer, bladder cancer, kidney cancer, etc. After the surgery, all catheters are withdrawn from the body and the patient can get out of bed after lying in bed for one day and one night, and the puncture opening is basically invisible after removing the bandage. In addition, we can also assist in local interventional treatment, such as chemical ablation, radiofrequency ablation, argon helium knife, particle implantation, etc. We can kill the tumor by directly puncturing the tumor lesion with a fine needle under the guidance of CT or ultrasound, and we can walk back to the ward after the operation with a band-aid on the puncture site, and there are very few complications. In chemoembolization, as long as the condition allows, the suspected tumor vessels can be injected and embolized through each vessel; if the review reveals that the embolization agent is partially defective, a fine needle can be directly punctured to the defective area of embolization, and 99.9 degree anhydrous alcohol (chemical ablation) or radioactive iodine particles (local radiotherapy) can be injected through the needle core, and argon helium knife can also be performed (the fine needle is connected to the outside equipment, which can lower the temperature of the lesion tissue to zero after it is turned on). (a fine needle connected to an outside device that can be turned on to lower the temperature of the lesion to minus 140 degrees Celsius to form an ice ball, and then raised to minus 20 to 40 degrees Celsius for rapid thermal therapy), radiofrequency ablation (the temperature is raised to minus 60 to 100 degrees Celsius to char the lesion directly), etc. Dr. Cao Guang Shao compares the interventional treatment of tumor to attacking a castle, the preliminary “hepatic artery chemoembolization” is equivalent to “comprehensive strike”, and the later auxiliary local treatment is equivalent to “targeted removal” of the residual stubborn molecules in the city. “The combination of “comprehensive strike” + “targeted killing” effectively makes the “enemy” of cancer The effective combination of “comprehensive combat” + “targeted killing” can make cancer, the “enemy”, have no place to hide. Of course, interventional treatment can also be used as an adjuvant treatment for surgical operation. “Hepatic artery chemoembolization” before surgical resection can make the lesions edematous and thus clearly delineated, which is convenient for resection and separation. “After surgery, “hepatic artery chemotherapeutic perfusion” is performed, and chemotherapeutic drugs are directly perfused into the liver tissue at the cut edge of the lesion or the suspected lesion that has not been completely resected, which will consolidate the efficacy of surgery and actively and effectively prevent recurrence or intrahepatic metastasis after surgery. –This will consolidate the surgical efficacy and actively and effectively prevent the postoperative recurrence or intrahepatic metastasis, which is usually called “Sandwich Treatment”. According to Prof. Li Tianxiao, deputy head of National Interventional Radiology Group and director of Henan Provincial Interventional Treatment Center, at present, the interventional department of Provincial People’s Hospital has two operating rooms: central catheterization room and minimally invasive tumor interventional operating room, which is one of the few hospitals in China that have both intravascular treatment and local treatment operating rooms under image guidance. In the operating room, we have installed and used advanced equipment at home and abroad, such as large flat panel DSA, American GE multi-layer spiral CT, color ultrasound, radiofrequency ablation instrument, particle treatment planning system, argon helium knife treatment system, Helio knife treatment instrument, ozone generator, etc. At present, for the first time in the province, “drug-laden microspheres” are used in cancer interventional treatment, which has better embolization effect, longer lasting drug effect and less toxic side effects. We are also actively negotiating for the purchase and installation of “magnetic resonance minimally invasive interventional navigation system”, which realizes “all-round minimally invasive treatment of tumor” in real sense. As Professor Wang Zhen Yu, the chief expert of Minimally Invasive Intervention Center and the chairman of Henan Provincial Minimally Invasive Tumor Treatment Committee, said, the Minimally Invasive Intervention Center of Provincial People’s Hospital has comprehensive technical means and rich clinical experience, and tumor patients coming here are like entering a large supermarket, and they can always find the suitable treatment method for themselves. We strive to make tumor a treatable chronic disease, so that the majority of tumor patients can live with tumor with dignity and quality. (Department of Interventional Medicine, Henan Provincial People’s Hospital)