Breast reconstruction surgery after mastectomy

The Hanoitimes – The twins are classified as a pair of very rare conjoined twins.

A pair of conjoined twins was successfully separated in Ho Chi Minh City on July 15, in an operation which involved more than 90 doctors, nurses and medical experts and lasted for 13 hours and 40 minutes, VnExpress reported.

Hoang Truc Nhi and Hoang Dieu Nhi were born prematurely on June 7 last year at Hung Vuong Hospital in the city. The two girls were joined at the pelvis. After birth, they were transferred to the Ho Chi Minh City Children Hospital to be raised and monitored.

The twins were classified as a pair of Ischiopagus Tetrapus (Quadripus) conjoined twins, which means they have a symmetrical continuous longitudinal axis with their area of union not broken anteriorly, according to doctors.

Over the past year, the twins had learned to sit up and coordinate with each other to move around despite their condition. Their parents, doctors and therapists all took great care of them daily, attending to their every need, from feeding them to changing diapers.

Two weeks before the surgery, the pair was administered antibiotics to prevent possible infections. The twins were deemed ready for the surgery after reaching 13 months, weighing 15 kilograms and having health statistics close enough to that of normal children.

Truc Nhi and Dieu Nhi shared parts of their ileums and colons, and a single anus. They also had two separate bladders on two sides of their belly. Two ureters led to the two bladders. Their pelvis was arranged similar to a circle.

Hoang Dieu Nhi and Hoang Truc Nhi before their separation surgery at the Ho Chi Minh City Children Hospital. Photo: VnExpress

The twins’ mother accompanied them all the way to the operating theater before parting ways and waiting outside with the father. Photo: VnExpress

The surgery started at 6:30am on July 15 at HCMC Children Hospital, and was expected to last for around 12 hours. Around 93 doctors, nurses and medical experts from several HCMC hospitals, including Tran Dong A, 79, a doctor renowned for successfully separating a pair of conjoined twins back in 1988, were on hand. Photo: VnExpress

The surgery went as planned. The surgeons managed to separate the two girls at around 2:10pm. Photo: VnExpress

Truc Nhi was then taken to another surgery room, while Dieu Nhi stayed on. The two will undergo reconstructive surgery to restore their appearance and some body parts. Photo: VnExpress

The surgery ended successfully at around 6:45 pm. The two girls were then transferred to a care unit in HCMC Children Hospital to be under observation. Photo: VnExpress

Doctors and nurses at the HCMC Children Hospital celebrate the successful separation of the two girls on July 15. Photo: VnExpress

The Ministry of Health and Vietnam Medical Association signed the MoU on January 19

The signing ceremony was hosted at the Ministry of Health (MoH) and chaired by Prof. Dr. Tran Van Thuan, Deputy Minister of Health, together with representatives from relevant departments and key hospitals.

The Deputy Minister said: “5-10 years ago, over 70 per cent of breast cancer patients visited hospitals and got treated at a late stage. In recent years, thanks to the communication campaigns, especially the national project on the prevention and control of non-communicable diseases including cancer, the rate of cancer patients getting medical examination and treatment in the early stage gradually increases.”

“The implementation of the project will contribute to the overall goal of the National Strategy on the prevention and control of non-communicable diseases, including cancer in 2015-2025. As this project is implemented nationwide with the cooperation between all levels of health departments and agencies, it is expected to bring positive and sustainable changes, leading to the improvement of Vietnam’s capability to respond to cancer,” he added.

The project aims to increase the rate of early breast cancer detection among women and improve access to advanced therapies for high-risk breast cancer patients. To achieve this goal, the MoH and Vietnam Medical Association will cooperate on the following areas:

(1) Increasing early detection of breast cancer through raising public awareness, screening for breast cancer, developing policy and professional guidance on breast cancer screening;

(2) Strengthening capabilities of medical system for breast cancer diagnosis and treatment;

(3) Develop real-world data system on breast cancer and optimise current data;

(4) Conduct general research on cost-effectiveness and policy on breast cancer screening status, survey drug use in treatment of high risk breast cancer patients.

This is the first time a specialised breast cancer project implemented nationwide with close-knit cooperation with stakeholders from all levels of government including the MoH, Social Insurance, Vietnam Health Insurance, professional medical agencies, hospitals including K Hospital, Bach Mai Hospital, Ho Chi Minh City Oncology Hospital, Hanoi Oncology Hospital, Cho Ray Hospital and the private sector, with Roche Vietnam playing the role of main sponsor for this project.

This signing ceremony demonstrates strong commitment among the government and healthcare departments to synchronise resources and provide simultaneous solutions to reduce the burden of disease on society.

Girish Mulye, chief representative of Roche Vietnam added: “As a global pioneer in pharmaceuticals and diagnostics, Roche is committed to working with Vietnam to address healthcare challenges through a variety of activities. Roche Vietnam is honoured to accompany Vietnam Medical Association and the MoH in this meaningful project, bringing new hope to breast cancer patients in Vietnam.”

Breast cancer is the top cancer of women in both developed and developing countries. Breast cancer incidence is on the rise in developing countries due to longer life expectancy, rapid urbanisation and changes in lifestyle. According to the Global Cancer Observatory 2020, in Vietnam, breast cancer ranks first among all types of women’s cancer, the number of new cases is 21,555 people, accounting for 25.8 per cent of cancer incidents in both genders, taking third place (after liver and lung cancer). The average age of breast cancer incidence in women is 34.2 per 100,000 people. In both genders, breast cancer mortality rate ranks fourth (with 9,345 cases) after liver cancer, lung cancer, and stomach cancer. The age-standardised mortality rate of breast cancer is 13.8 per 100,000 people.

While certain risks of breast cancer can be reduced through prevention, this strategy cannot eliminate the majority of developing breast cancers in low and middle-income countries, where breast cancer is diagnosed at a very late stage. Therefore, early detection to improve breast cancer treatment outcomes and survival are the cornerstone in controlling breast cancer. At the same time, improving access to innovative therapies is crucial in breast cancer control and management.

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This lunar New Year (Tet), all 63 personnel of Vietnam’s Level-2 Field Hospital (L2FH) Rotation 2 in South Sudan should have been reunited with their families in Vietnam. However, their tenure has been extended for a couple of months due to the COVID-19 pandemic. Though they have to enjoy another Tet away from home, they are still happy to celebrate with many meaningful activities, contributing to beautifying the image of Vietnam among international friends.

Doctor Koma Akim’s story

From Bentiu, South Sudan, Lieutenant Colonel Nguyen Quang Chien, Deputy Director of the hospital began his talk about the hospital’s support for local people with the story of his South Sudanese colleague named Koma Akim, a staff member at Bentiu Hospital.

Acting Minister of Education of Bentiu presenting Vietnam’s L2FH Rotation 2 a certificate of merit for its active engagement in civilian-military coordination activities in the place it is stationed

The story started with a quote from the mother of 13-year-old patient Miss Nyakola Tely, “My daughter is alive. Thank God and pray to God for Vietnamese doctors who operated on my daughter.”

Previously, Doctor Akim seemed helpless to perform a surgery on the child patient to remove a giant tumor on her right thigh because of the lack of gigli saw, an indispensable medical device needed for an amputation surgery. Luckily, the “miracle” appeared and he promptly received not only the gigli saw, but also other necessary medical equipment from Vietnamese doctors to help him complete the surgery.

Doctor Koma Akim and his colleagues from Bentiu Hospital were so touched with the timely assistance of Vietnamese doctors that he did not know how to express his deep thanks to the Vietnamese doctors in general and Dr. Chien in particular. At last, he decided to email the life-saving story of Tely to all of the agencies under the UN Mission in South Sudan in the hope of spreading this meaningful story as a special way of expressing gratitude to the Vietnamese doctors.

According to Lieutenant Colonel Vo Van Hien, director of the L2FH Rotation 2, in spite of facing numerous difficulties and shortages of equipment amidst the COVID-19 pandemic, the hospital’s staff is always ready to give support to the host country, even if they have to save a pill or a medical facemask.

In fact, Vietnam’s field hospital has become a reliable health-care address, and a place for spiritual support for the UN Blue Beret Force in Bentiu. Health units under the UN mission are not the only ones that rely on Vietnam’s field hospital, but also local hospitals have asked for the field hospital’s professional assistance and medical equipment during times of difficulty. With the spirit of “a good doctor is like an affectionate mother,” and getting approval from the UN Mission’s medical agency, the field hospital of Vietnam has never refused any request for medical assistance. The hospital’s hotline is available around the clock to give assistance to any patient.

As a good South Sudanese surgeon, who graduated from abroad, doctor Akim always trusts the Vietnamese colleagues and often consults with them. Once visiting the hospital for medical consultations, he was moved when the hospital staff made and presented small gifts, including drawing paper and crayons, to child patients under treatment at Bentiu Hospital. Akim showed Chien the photos of the patients receiving the crayons with joy on their faces and messaged that “My heart was broken when I saw children with such great potential in a skinny and sick condition.”

Though he could find a better job abroad, doctor Akim still prefers to work at Bentiu Hospital and he is happy because his humanitarian spirit is shared by Vietnamese colleagues.

Doctor Chien said that he asked doctor Akim to maintain the good relationship between Bentiu Hospital and Vietnam’s L2FH for the benefit of the local people.

In each gift to Bentiu primary students, there is a small piece of paper attached with information about Vietnam and late President Ho Chi Minh. Photo: Trong Tinh

According to doctor Tu Quang in charge of civilian-military coordination (CIMIC) activities of the field hospital, apart from their professional duties, the hospital’s personnel are responsible for making contributions to changing the lives of locals for the better. Through civilian-military coordination activities, Vietnamese doctors expect to spread the humane spirit of the Blue Beret Force.

Soldiers on the frontline

In the context that South Sudan is a COVID-19 flashpoint, the field hospital of Vietnam is assigned by the UN Mission to be one of the key hospitals on the frontline to fight the pandemic.

Last year, along with applying COVID-19 prevention and control measures, the Vietnamese hospital also carried out five programs to support South Sudan people in Bentiu. One of their programs involved making 31 sets of desks and chairs with Vietnamese and South Sudan flags and 100 sets of learning tools, toys and alphabet letters from recycled plastic products to present to Bentiu Primary School. This program was initiated by non-commissioned Senior Lieutenant Vu Anh Duc after a visit to a civilian protection area where he saw classrooms lacking essential items.

Each gift presented to the primary students was attached with a small piece of paper with English words introducing Vietnam and Late President Ho Chi Minh. As doctor Tu Quang said, he hoped that the children would learn more about Vietnam, a small, resilient country, half of the size of South Sudan, which underwent wars and has reaped great development achievements. He hoped this would inspire them to study hard to support their families and contribute to rebuilding South Sudan.

Regarding the civilian-military coordination activities of the Vietnam’s field hospital, Ms. Geraldine Chioma Nzulumike from the Reconciliation and Reconstruction Office and an envoy of the Head of the Field Office said that the deeds that Vietnamese doctors have done are typical for UN’s activities in South Sudan. These activities demonstrate the UN’s commitment to contributing to South Sudan’s sustainable development and peace. Vietnamese doctors have also inspired local students. She added that “if the hands with skills in surgeries and examinations can make such beautiful desks, tables and alphabet letters, you (South Sudanese students) should not be afraid to learn new things and try new things that are useful to the community and society!”.

Translated by Mai Huong