Introduction to the departments of Beijing Public Security Hospital

The Lymphatic Disease Treatment Center of Beijing Public Security Hospital is the only unit in Beijing that specializes in treating lymphedema and chylous reflux diseases mainly by microsurgery, and it is also the only medical discipline in China that specializes in the diagnosis and treatment of lymphatic diseases. 200 1 Together with 25 different disciplines, such as ophthalmology of Beijing Tongren Hospital and urology of Peking University First Hospital, it was established as a key discipline project of capital medical development by Beijing Municipal Health Bureau, and the diagnosis and treatment of lymphatic diseases was at the leading level in China. Due to the system reform, Beijing Public Security Hospital was transformed into an administrative unit, and its personnel status was changed to a national civil servant. Beijing Public Security Hospital no longer exists. Because civil servants cannot engage in business activities, they cannot continue to treat patients from all over the country. In order to continue to develop the specialty of lymphatic surgery and provide better diagnosis and treatment services for many patients with lymphatic diseases in China, doctors such as Shen, Sun Yuguang, Xia Song and Chang Kun gave up their civil servant status and transferred to Beijing Shijitan Hospital to rebuild lymphatic surgery with the old director Geng Wande. Beijing Shijitan Hospital (formerly Beijing Railway General Hospital) is a third-class first-class hospital directly under the Beijing Municipal Health Bureau and one of the top 100 hospitals in China. Lymphatic surgery is an independent specialty and ward with 30 beds. Bus route: Take bus No.20. 2 1, 320, 4 14, 2 12, 827, get off at Beijing Millennium altar hospital. Take bus No.40, No.205, No.724 and No.5, get off at Beijing West Railway Station and walk 200 meters north. Get off at the subway military museum station, exit B, and transfer to 2 1, 320, 4 14, 827, special 6, special 5. Geographical location: Beijing Millennium Monument Hospital (formerly Beijing Railway General Hospital) is located in the south of Haidian District, Beijing, opposite to CCTV, China Millennium Monument and Military Museum in the north, adjacent to Beijing West Railway Station in the south, Ministry of Railways in the east and Wangcheng Town and Country Business Center in the west. The hospital is adjacent to Fuxing Road in the north, leading to Chang 'an Street and Beijing West Railway Station in the south. There are Railway Building, Jingxi Hotel, Kerry Hotel and Kyoto Xinyuan Hotel nearby, with convenient transportation and accommodation. 1. Overview of Lymphatic Surgery: Lymphology is a new discipline that conducts basic and clinical research on the lymphatic system. It has been 40 years since the establishment of the International Lymphology Society. As a new frontier discipline engaged in the diagnosis and treatment of lymphatic diseases, lymphatic surgery is still in its infancy.

According to the estimation of International Lymphology Society, there are about1400,000 lymphedema patients in the world. Academician Zhang of China Academy of Engineering, who has been engaged in the research of lymphatic reflux disorder for many years in China, pointed out that the total number of people suffering from lymphedema in China is estimated to be around 4 million, and at least 654.38+00000 patients need surgical treatment after breast cancer surgery. Celiac disease is a rare, complicated and refractory manifestation of lymphatic reflux disorder. It is estimated that there are thousands of new cases of various chylous reflux diseases in China every year. In the face of many patients with lymphatic diseases, there is a lack of medical institutions that systematically and professionally study the disease in China.

The Department of Lymphology of Beijing Public Security Hospital, under the leadership of Director Geng Wande, has carried out the clinical research of Lymphology for 18 years. At present, it is the only clinical medical unit specializing in the diagnosis and treatment of lymphatic reflux disorder in China, and the level of disease diagnosis and treatment in this professional field is in the leading position in China.

Second, the development of lymphatic surgery specialty

Lymphatic surgery, as a lymphatic specialty group of general surgery, began to carry out the clinical work of micro-anastomosis of lymphatic veins to treat lymphedema of limbs on 1988. Since then, it has gradually developed into a professional clinical medical unit engaged in the diagnosis and treatment of lymphatic diseases, covering various types and parts of lymphedema.

Since 199 1, members of the professional group have further participated in the research on the diagnosis and treatment of chylous reflux disease. The professional scope is expanding, and the level of disease diagnosis and treatment and the number of patients are increasing. This specialty group was awarded 199 key discipline project of the Capital Medical Development Research Fund of Beijing Municipal Health Bureau (the first batch), and became one of the key disciplines of medical development in tertiary hospitals in Beijing 18, and was also supported by the fund of1600,000 yuan. In 2000, the Lymphatic Disease Diagnosis and Treatment Center of Beijing Public Security Hospital was established. In order to meet the growing needs of patients, in 2004, Beijing Public Security Hospital established an independent ward for lymphatic surgery with 29 beds. After the public security hospital was abolished in 2007, Beijing Shijitan Hospital set up an independent lymphatic surgery ward with 30 beds.

Beijing Public Security Hospital

Three. Overview of lymphatic surgery

Lymphatic surgery has conducted long-term research on the diagnosis and treatment of lymphatic diseases. Professional diagnosis and treatment, as well as centralized treatment of cases, the research work has made great progress. With the deepening understanding of the disease, undergraduate course has become a professional clinical department with the widest range of lymphatic diseases, the most comprehensive diagnosis methods and the most surgical methods in China, and the diagnosis rate and treatment efficiency of the disease are also in the leading position in China. 1, business scope

It can be divided into lymphedema and chylous reflux disorder. Lymphedema includes primary lymphedema, secondary lymphedema, tumor-associated lymphedema, lymphangioma and lymphatic fistula. According to the location, it is divided into limb and facial lymphedema; Chyloid reflux diseases include chylothorax, chylothorax, chylothorax of lower limbs and external genitalia, chylothorax diseases of intestine, chyluria, chylothorax, multiple chylothorax and chylothorax cyst.

2. Diagnostic methods

Including improved direct lymphangiography, indirect lymphangiography, radionuclide lymphography, intestinal loss test of radionuclide labeled albumin, lymph enhanced ct, MRI, qualitative and quantitative analysis of chyle, etc.

Step 3: Treatment

Lymphatic surgery majors use multidisciplinary diagnosis and treatment techniques such as microsurgery, vascular surgery, general surgery, thoracic surgery, plastic surgery and urology.

Surgical treatment includes improved microscopic superficial/deep lymphangiovenous anastomosis (LVA) for lymphedema of limbs and face; Severe lymphedema was treated by excision and plastic surgery, such as Charles operation and modified Kondoleon operation. Reconstruction of chylous reflux pathway, such as thoracic catheter external jugular vein anastomosis, retroperitoneal LVA, external iliac LVA, autologous saphenous vein transplantation LVVA, peritoneal-venous bypass, etc. Treatment of retroperitoneal low chylous reflux by resection of retroperitoneal lymphatic vessel transection ligation area: Open exploration, intraoperative lymphangiography combined with endoscopy and pathological bowel resection were used to treat protein-lost enteropathy caused by intestinal lymphangiectasis. Lymphatic drainage, thoracic duct ligation, pleural cavity adhesion, scrotum and labial plasty, chylous fistula adhesion and other operations were also performed. Conservative treatment mainly includes total parenteral nutrition support for severe lymphatic fistula and severe chylous diseases.

Fourthly, the academic achievements of lymphatic surgery.

1, Diagnosis and treatment of limb lymphedema

The improved indirect lymphangiography technique was used to judge the structure and function of lymphatic vessels in affected limbs, and more than 300 cases were completed, making it the largest case group in China. Microlymphatic vein anastomosis for limb lymphedema is nearly 1000 cases (Campissi group has the largest number of reported cases in the world, 1000 cases, Microsrugery, 2006; 26( 1):70-72)。 More than 300 cases of deep lymphatic vein anastomosis have been carried out, which has not been reported at home and abroad. The clinical study of lymphedema caused by malignant tumor was reported for the first time in China.

2. Diagnosis and treatment of chylous reflux disease.

Nearly 300 cases of direct lymphangiography (the puncture site can reach limbs, face and digestive tract) were completed under the operating microscope of the catheter room independently improved by undergraduates, and the success rate was as high as 97%, which was much higher than that reported in the literature. This kind of examination is rarely carried out in other hospitals in China. 200 1 It was first reported at the International Congress of Lymphology that direct lymphangiography (lymph-enhanced ct) was used to diagnose chylous reflux diseases immediately after CT images. This method greatly improves the diagnostic accuracy of chylous reflux disease.

Retroperitoneal ligation of lymphatic vessels+microlymphatic anastomosis of iliac lymphatic vessels or lumbar lymphatic trunks, microlymphatic anastomosis of external jugular vein of thoracic catheter for the treatment of lower extremity chylothorax, and inguinal chylothorax-lateral femoral vein anastomosis for the treatment of chylothorax have not been reported at home and abroad.

300 cases of chylous reflux disease were treated, including chylous hydrothorax and ascites 150 cases (40 cases were reported as the largest case group in China, Shen, Chinese Journal of Surgery. 2005,43( 1)); 70 cases of chylous reflux lymphedema of lower limbs were treated (it is reported that the largest case group in the world is Servelle group, with 55 cases in surgery,1987; 10 1:485-500); Treatment 15 cases of protein-deficient enteropathy caused by intestinal lymphangiectasia (all cases were reported at home and abroad).

3. This major was awarded the first batch of key discipline projects (type I project ZD 1998 18) by the Capital Medical Development Research Fund (approved in September 2000), and was supported by the research fund1600,000 yuan.

4. In 2003, the undergraduate participated in the first national conference on lymphology held in Shanghai and made seven speeches (***30 delegates made speeches). Through communication, the undergraduate course has established a leading position in clinical diagnosis and treatment in this field. Five undergraduate participants became one of the founders of the National Lymphology Society, and Director Geng Wande became a member of the technical committee.

6. In 2004, the paper "Diagnosis and treatment of chylothorax" written by Shen et al. won the first prize in the 7th National Symposium for Young and Middle-aged Physicians in General Surgery jointly organized by Surgery Branch of Chinese Medical Association, Chinese Journal of Surgery and Chinese Journal of General Surgery, and Xia Song et al. won the third prize in the excellent paper "End-to-end anastomosis of external jugular vein of thoracic duct for the treatment of chylothorax reflux disease".

7. On the basis of rich clinical experience in this field, and referring to the works about lymphology at home and abroad, lymphatic surgery has revised and improved some theoretical viewpoints that have been proved to be outdated and obviously flawed, and formulated the diagnosis and treatment routine of lymphatic surgery, thus making the clinical work of lymphology a complete and systematic practice standard.

8. In recent years, with the improvement of discipline construction and professional level, the number of out-of-hospital consultations has increased significantly. In Peking Union Medical College Hospital, 30 1 Hospital, Beijing Hospital, Peking University First Hospital, People's Hospital, Beijing Third Hospital, Friendship Hospital, anzhen hospital and other tertiary hospitals, including hospitals in Zhejiang, Yunnan, Fujian, Jiangsu and Guangdong, 19 patients were consulted, and doctors from other hospitals have been accepted for further study. Academic level has been recognized by many people in the industry.

9. The compiling unit of the teaching material "Lymphatic diseases" of "Management of Vascular Lymphatic Surgery Diseases-Review, Present Situation and Prospect" planned by the Ministry of Health for medical postgraduates in national colleges and universities.

10, the undergraduate published 4 papers at the 2007 International Lymphology Society 2 1 International Conference.