評論
打印
"The problem with neurosurgery," says Eelco Hoving, a pediatric brain surgeon, "is that it is very unforgiving."
小兒腦外科醫生埃爾科·霍文說，“神經外科的問題在于它非常無情?！?/div>
Even the specialists often have to start by cutting into someone's head to get a better idea of what they're treating.
即使是專家也常常必須從切入某人的頭部開始，才能更好地了解他們正在治療的疾病。
In the case of neurological tumors, for instance, you often don't know what you're dealing with until you remove a flap of skull and biopsy a small portion of brain tissue for analysis.
例如，在神經腫瘤的情況下，你通常不知道自己在處理什么，直到切除一塊顱骨并活檢一小部分腦組織進行分析。
That's how things work at the Princess Máxima Center, a partner of UMC Utrecht, one of the biggest research hospitals in the Netherlands, where Hoving is the clinical director of neuro-oncology.
這就是瑪西瑪公主小兒腫瘤中心的運作方式，該中心是荷蘭最大的研究醫院之一烏得勒支大學醫學中心的合作伙伴，霍文是該中心神經腫瘤科的臨床主任。
The sample is then sent to the lab, where two things happen.
然后樣本被送到實驗室，在那里發生兩件事。
The pathologists sequence and profile the brain tissue and attempt to identify what kind of tumor is present, a laborious process that can take a week, often longer.
病理學家對腦組織進行定序和分析，并試圖確定存在哪種腫瘤，這是一個費力的過程，可能需要一周甚至更長的時間。
In parallel, the lab takes a small cross section of the sample, freezes it, and thinly slices it with a scalpel -- effectively taking a "frozen snapshot," says Hoving -- and then reviews it under a microscope in a process called a quick section.
同時，實驗室會采集樣本的一小部分橫截面，將其冷凍，然后用手術刀將其切成薄片，霍文說，這實際上是拍攝“冷凍快照”，然后在顯微鏡下對其進行檢查，這個過程稱為快速切片。
While a quick section can help identify what kind of tumor is present in just 15 to 20 minutes, it's far less reliable than the slower method.
雖然快速切片可以在短短15到20分鐘內幫助識別腫瘤類型，但它的可靠性遠不如較慢的方法。
This leaves neurosurgeons with a dilemma as the patient lies there, brain exposed.
這讓神經外科醫生陷入了兩難的境地，因為病人躺在那里，大腦暴露在外。
A series of tricky determinations is made with imperfect information: Is there actually a tumor here?
利用不完整的信息做出一系列棘手的決定：這里真的有腫瘤嗎？
And if it is in fact cancer, is it an aggressive form that needs to be excised quickly?
如果它確實是癌癥，那么它是否是一種需要快速切除的侵襲性形式？
Or is it a milder tumor that can be treated with something less invasive, like chemotherapy?
或者它是一種較溫和的腫瘤，可以用化療等侵入性較小的藥物來治療？
Hoving specializes in operating on kids and teenagers, so he understands these limitations viscerally.
霍文專門從事兒童和青少年手術，因此他內心理解這些限制。
He remembers operating on a young patient a few years ago.
他記得幾年前曾為一名年輕病人做過手術。
The quick section indicated a highly malignant embryonal tumor called an ATRT.
快速切片顯示出一種高度惡性的胚胎腫瘤，稱為ATRT。
Because ATRTs are aggressive, Hoving decided the best course of action was to respond aggressively in turn.
由于ATRT具有攻擊性，霍文認為最好的行動方案是依序積極回應。
He made the call to perform a radical resection, carefully taking out more than 98 percent of the tumorous tissue -- a deliberate and mentally draining process that requires unblinking concentration for hours on end.
他決定進行根治性切除手術，小心翼翼地切除98%以上的腫瘤組織--這是一個深思熟慮且耗費精力的過程，需要連續幾個小時目不轉睛地集中注意力。
As a result of the procedure, the patient lost some motor control in one of his arms.
手術的結果使得患者的一只手臂失去了部分運動控制能力。
