Transbronchoscopic emphysema lung decompression

  Prof. Cooper was giving a lecture on lung transplantation lung decompression at the 14th World Congress of Thoracic Surgeons in Beijing in 2003, and I was his simultaneous interpreter.  On April 23, 2001, I invited Prof. Cooper (USA) and Prof. Maiwand (UK), President of the International Society of Cryosurgery, to visit China on a personal basis. Group photo in front of Kunlun Hotel.  On April 23, 2001, I chaired the national lung transplantation lung decompression and new advances in thoracic surgery techniques at the China-Japan Friendship Hospital in Beijing, and invited Prof. Cooper (USA) and Prof. Maiwand (UK), President of the International Society of Cryosurgery, to make a presentation at the conference. Group photo with President He Huiyu, Vice President Liu Xiaoqin, Secretary of the Party Committee, and mentor Professor Xin Yuling on the podium.  From April 12 to 14, 2013, the 6th National Advanced Symposium on New Advances in Bronchoscopic Interventions was held under the auspices of Prof. Wang Hongwu of Beijing Coal General Hospital, the chairman of the conference, and the Respiratory Endoscopy Branch of the Chinese Anti-Cancer Association’s Specialized Committee on Tumor Interventional Treatment was established. The conference exchanged the progress of pulmonary decompression (transbronchoscopic pulmonary decompression) including emphysema in internal medicine, and many famous respiratory endoscopy experts from Beijing and Shanghai, made the conference report and exchange. Bronchoscopic lung decompression has become a widely used clinical technique, bringing benefits to a large number of patients with severe emphysema. We sincerely congratulate the success of the event.  Brantigan was the inventor of pulmonary decompression in 1957, and its principle was scientific. The surgical removal of non-functional lung tissue restored the elastic retraction force of the remaining lung to normal, reducing ineffective dead space and improving lung function. However, the level of science and technology at that time was not sufficient to ensure the safety of the operation, and the mortality rate of the operation was as high as 16%. Therefore, it was not carried out clinically. Things in the world are like this for thirty years and thirty years. Emphysematous lung decompression was successful forty years later! When it comes to modern lung decompression, Dr. JD Cooper of the United States must be honored. He is recognized worldwide as a pioneer in lung transplantation, the first to achieve clinical success in lung transplantation, and the world’s leading expert in lung transplantation. 1995 saw the publication of his article on successful lung decompression, which opened up yet another field of medicine. Success relies on the combined use of mechanical sutures and biological or artificial materials, a result of scientific and technological developments. However, conventional open lung decompression surgery, which is more traumatic, still has certain mortality and complications. We were the first to carry out lung decompression surgery in China, and after doing one side lung decompression for a professor from Peking University in 2006, the patient could browse Mount Huangshan, and then did the opposite side lung decompression for him in ’07, and later he surprisingly climbed Mount Emei. This greatly encouraged our confidence to carry out lung decompression. However, the complications and mortality of lung decompression are still my main consideration. Based on the principle of pulmonary decompensation, it is linked to the experience of many years of career in pulmonary surgery. I have been concerned about the middle lobe syndrome, and there is no shortage of clinical cases where the middle lobe lung ends up in complete fibrosis without a serious infectious process after the middle lobe atelectasis. This is called “internal pneumonectomy”. So, it occurred to me, why not achieve the same effect as resection of the target lung tissue by obstructing the target bronchus and causing the target lung tissue to atrophy? At that time, I happened to be helping a manufacturer with a clinical trial of bioprotein gel, so I used it to try bronchoscopic lung decongestion in a patient. The result was a great success.  This was a 62-year-old male patient who had been mechanically ventilated by tracheal intubation for more than 1 month due to pulmonary emphysema and respiratory failure, and several attempts at decannulation had failed. I saw that the patient’s right upper lung was an obvious target area, so I successfully blocked the bronchi of each lung segment in the right upper lobe with bioprotein gel, resulting in successful decannulation after 48 hours, and the tracheotomy tube was removed 4 days after decannulation. The patient recovered and was discharged with six months of follow-up and life management.  This was an endoscopic lung decompression done in March 2000. It was the first successful transbronchoscopic pulmonary decongestion in the world! In October of the same year, it was published in Sino-Japanese Friendship Journal, Vol. 14, No. 6, pp. 345-6, entitled “Bronchial occlusion method of pulmonary decongestion for chronic obstructive pulmonary disease”. In order to expand the influence, the results were published in June 2001 in the Chinese Journal of Thoracic and Cardiovascular Surgery, Vol. 17, No. 3, under the title of “One case of emphysema treated successfully by pulmonary decompression with bronchial occlusion method with ventilator discontinuation”. This is the first case of pulmonary decongestion in internal medicine in the world to be published in the literature. The idea is based on my many years of medical experience, so it is “Original”!  Unfortunately, it is not well documented in the domestic literature. For this reason, I have affirmed this to the relevant journals, hoping that Chinese scholars will not be presumptuous, and that the first inventions of Chinese people in the world should be our pride, and that we should respect science and first inventions. Especially in international forums, we should cite and publicize them widely. I hope this article will help to establish this style of writing!  Why did you write this article? Because when I was studying in the United States, I heard an American friend say clearly that Japanese people are better than Chinese people. I asked why? He said you Chinese are “sneaky”. Aren’t we sneaky?  In 2002, I invented the world’s first Zhao’s artificial trachea. A kind of secondary surgery, using memory alloy mesh as a stent, can achieve biological healing with the autologous trachea, was hailed by “China Today” magazine as “the closest artificial trachea to the real thing” (Tha artificial trachea-Llosest to the real thing). In that year, it was awarded by China Medical Tribune as one of the top ten medical news in China and one of the top ten clinical news in the world (my artificial trachea was the only one elected in China that year). The Xinhua News Agency sent a picture news to the whole world, and a large number of media made detailed reports. However, a few years later, a doctor in China, who had successfully completed one case exactly according to my method without any modification, sent the case report to an influential foreign journal of thoracic surgery with “original”, without mentioning me as the founder or the learned technique. When a major professor in Shanghai saw the article, he sent me a text message saying that someone had stolen your technique and sent the article to a foreign journal. I laughed it off. Anyway, I had already published it in China, and it didn’t matter who did the surgery, as long as it was Chinese, as long as it was Chinese results! But when you think about it, this doctor, don’t you sneaky!  I hope the party style to be right, it is difficult! But I hope the academic style to be right, should not be difficult! We’re not party bangers, we’re not political liars! We are scientists, we are doctors who treat the sick and save people! I hope each of us starts with me and corrects the style of learning! I hope that we can all start from ourselves and correct our learning style, and get rid of the dishonest hat, and get rid of the outsiders think we are sneaky!