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What is a head gamma
knife? |
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Is the gamma
knife a matured therapeutic method? |
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Does
a gamma knife surgery cost more than a conventional
craniotomy? |
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How is a gamma knife surgery performed? |
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What points should patients pay attention to before and after
head gamma knife treatment? |
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How do we observe clinical effects of a head gamma knife surgery?
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What is a head gamma
knife? |
The gamma knife is actually not a knife.
It is a kind of an extremely
advanced radiosurgical device. Its scientific name is:
Gamma-Ray Stereotatic Treatment System. It works by delivering beams of
gamma rays into the human body from various directions
and focusing them on the target tissue. Because a single ray
of radiation is not strong enough to affect the tissues, but a
concentration of a large quantity of beams can unleash magic
power to kill the disease focus at one time just like a
scalpel. It is proven that the system can offer quick, safe
and reliable magic curative effects without incision, bleeding,
infection and
pain.
Gamma
knife works similarly as a magnifier. Put a magnifier under the sun and you will
find a dazzling bright spot under the magnifier. The bright
spot is the focus. The temperature on the focus will be
increased quickly so that it can cause some
substances to burn but the temperature outside the focus will
be almost unchanged. It is impossible, of course, to focalize
the sunlight within the human body, so we have to use a kind
of high-energy high-penetrability ray such as gamma ray.
Meanwhile, focalization of gamma ray, not as simple as that of
magnifier, should be based on comprehensive utilization of
various modern technologies such as nuclear physics,
computer, bioradiology and electromechanism. Therefore, gamma
knife, as a brand new non-invasive therapeutic method, is a
crystallization of high technologies at the end of 20th century
and a revolutionary breakthrough in the history of medical
treatment.
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| Is
the gamma knife a matured therapeutic method?
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At present, most people even some
medical experts don't have a thorough understanding of gamma
knife. However, gamma knife, as a hi-tech therapeutic method,
has underwent thirty years of evolution, with good curative
effects and high safety.
Gamma knife was developed by a Swedish neurosurgeon in
1968. Subject to a large number of animal experiences, gamma
knife has been put into clinical use since the 1970's. Up to now,
beyond 100 gamma knifes in the world have been used to treat over 50,000 patients
altogether worldwide. In special, the traditional surgery has
even tended to give a way to radiosurgery for curing some
special diseases.
It is until the 1990's that gamma knife has been
initially used in
China and it is also until the 1990's that gamma knife begun
to have a popular utilization in the world. That is because
the international medical circle assumed a prudent attitude to
the use of it. Over twenty years of worldwide clinical
experience has proved that gamma knife surgery features
obvious effects and zero mortality rate. Of course, it is
necessary for operators to have a overall grasp of basic
knowledge concerned before the utilization of gamma knife. It
is just like what professor Wang Zhongcheng, a famous neurosurgeon in
China, said: gamma knife surgery is safe and reliable
but the manipulation should be correct and the radiosurgery
should be confirmed to suit for
the patient.
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Does
a gamma knife surgery cost more than a conventional craniotomy?
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Gamma knife is a very
expensive large medical equipment. Each costs over RMB 20
million so the service expenditure is very high too. According to
different situations, a gamma knife brain surgery costs about RMB
15,000 to 25,000.
A conventional craniotomy in China now costs at most RMB several
thousands. However, a conventional craniotomy has to entail other fees,
such as, medicine fees, check fees, hospitalization fees,
nursing fees, nutrition fees and a considerable sum of fees
due to loss of work for a long time after operation. But the gamma
knife brain surgery can avoid all of these fees. In this way,
expense of a gamma knife brain surgery is almost as same as that of
a conventional craniotomy. According to statistics, a gamma knife brain
surgery
costs slightly higher than a conventional craniotomy (comprehensive cost)
in the remote and backward regions while the former costs
almost as same as the latter in the off-shore and developed
regions in China. If taking pain and risk into consideration,
gamma knife brain surgery is obviously more
cost-effective.
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| How
is a gamma knife brain surgery performed?
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 Gamma
knife is operated by a team of professional personnel who must
have received specialized training. A patient cannot receive
gamma knife treatment until he or she has underwent a series of checks
first to make sure he or she is suitable
for gamma knife radiosurgery. Before raidosurgery, the patient should be fixed
with a stereotatic frame on his or her head under local
anesthetic for MRI/CT scan.
After MRI or CT scan, the patient can have a rest
while doctors will input the scanned outcome into a computer. The computer will automatically
formulate a therapeutic solution and then transmit it to the
gamma knife control system.
For gamma knife treatment, first let the patient lie on
his or her back on the surgical bed, and then fix the head
of the patient and make some necessary measures to protect his
or her sensitive parts and finically start up the control
system. The control console will maneuver the gamma knife that
is used to perform the surgery according to the received
orders. In the whole period of radiosurgery, the patient is
sober without pain and discomfort. Meanwhile, the doctors can
observe and ask the patient for his and her conditions during
the operation through cameras and interphone system.
Remove off the stereotactic localization frame from the
patient after the therapy is over. Most patient can leave
hospital immediately after the treatment. However, the
patients who have comparatively larger lesion or more
complicated clinical conditions prior to the treatment may
stay in hospital for one or two days of observation.
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| What
points should patients pay attention to before and after head gamma knife
treatment? |
In view of distinctive features of gamma
knife radiosurgery, patients have few points for attention.
They do not have to abstain from eating or water drinking, or have a haircut or have a general anesthesia. Besides, the
elder, weak and patients who have obvious
complication (who suffer from heart, liver or kidney disease) or cannot
receive other surgical operation are all suitable for gamma
knife treatment.
（1）Patients have to take off all metal objects
before gamma knife radiosurgery. After precision positioning
through a MRI or CT scan, doctors need some time to make out a
solution. Patients can have a rest during the period. In case
of any comfort, they can contact doctors immediately.
Most of patients will have no obvious side effects after
gamma knife treatment, and they can leave the hospital after clinical observation. Only a few patients, especially those
who have received large dosage of radiation at a time, may have
some side effects, such as, headache, naupathia, vomit, fever
and so on. It is mostly caused by damage of capillary vessel, edema
or infection due to radiation. However, the side effects just
lasts a short period of time and they can disappear more
quickly with the assistant of medicines such as dehydrator.
Some other few patients may suffer from slight maladjustment
of movement, local numbness or other neural disorders within a
few of weeks or months after the treatment, but they can also be
recuperated by themselves or under the help of medicines. Once
some patients have such symptoms after gamma knife treatment,
do not worry and go to consult doctors or take some medicines
for precautions according to doctor's advices.
（2）After treatment, the patients shall be
re-examined at regular intervals according to them own
conditions and doctor's recommendations. |
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| How
do we observe clinical effects of a head gamma knife surgery?
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Gamma knife treatment is a kind of
radiotherapy. Different from traditional surgical operation that
can remove the morbid tissue at a time, gamma knife
treatment requires a long-term period for gradual metamorphosis
and putrescence after the garget tissue has been irradiated. Generally the period can be divided into the
following three stages:
1.Stage of Putrescence: The tissue subject to radiation
will have an acute regressing change and inflammatory reaction
within three to four weeks after gamma knife radiosurgery.
2.Stage of Absorption: The fragments of the target
tissue's cells will be gradually absorbed, glial cells will be
generated, blood vessel will be blocked, intradermal cells
will be generated and new capillary vessel will be formed in
the following year after the stage of putrescence.
3.Later stage: In the following years after gamma knife
treatment, inflammatory reaction will gradually disappear,
collagen scar will be formed and new capillary vessel will not
be generated any more.
Therefore, curative effects of gamma knife treatment is
durative and gradual, and thus we can not judge it immediately after the operation. A benign tumor, for example,
will stop growing after radiation, and it will shrink obviously
within the following three to six months. Then various
clinical symptoms will gradually
disappear. After treatment, the patients shall be
re-examined at regular intervals.
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