A unique case: at the P. Hertsen Moscow Oncology Research Institute, a large retroperitoneal tumor was removed laparoscopically for the first time

Lasr year in December , suddenly something started stabbing in the right side, and Galina Nikolaevna, a patient of our Center, went to the local therapist, and after analysis, he referred her to an oncologist. Unfortunately, the cancer diagnosis was confirmed. CT results showed that the neoplasm in the inferior vena cava, one of the most important vessels of the body, spreads to neighboring organs: the right kidney and adrenal gland, liver, and duodenum. In addition, the tumor thrombosed both the inferior vena cava and the right renal vein and spread to the diaphragm. Seeing this, oncologists at the place of residence did not dare to perform such a complex and dangerous operation: removing such a tumor without consequences is one percent out of a hundred. We need not just oncological surgeons, but specialists with experience in vascular surgery. And they advised me to contact the P. Hertsen Moscow Oncology Research Institute – branch of the Federal State Budgetary Institution of the “National Medical Research Radiological Centre” of the Ministry of Health of the Russian Federation.

While the confused Galina Nikolaevna was “getting her thoughts together,” the symptoms of the tumor became more expressed: by July the pain intensified, signs of difficulty eating and digesting food appeared with all the ensuing complications. Consilium of specialists from the P. Hertsen Institute, taking into account the high risks of surgery, decided to start treatment with chemotherapy.

As the General Director of the Center, Academician of the Russian Academy of Sciences Andrey Kaprin, says, the patient’s attitude was very important: “If they are in league with the doctor, the disease has no advantage.”

️After a detailed analysis of the treatment plan with doctors, Galina Nikolaevna firmly decided to defeat the disease, and the body responded to chemotherapy. During a control CT scan of the abdominal organs, doctors saw that the tumor began to recede from neighboring organs and decreased, and the patient’s well-being improved.

 Now when the tumor process has stabilized, the doctors unanimously came to the conclusion: it is possible to operate and save both the liver and the intestine.

“Thanks to the competent attitude of oncologists at the place of residence, who promptly sent the patient to our Center for a second opinion, we were able to help her,” says attending physician Marina Pavlovna Makurina.

“As a rule, such operations are performed through extensive, often combined approaches to the anterior abdominal wall, which are highly traumatic and violate its integrity,” explained Andrey Ryabov, Deputy Director General for Surgery at the National Medical Radiology Research Centre of the Ministry of Health of the Russian Federation. “And most importantly, this intersects the formed collaterals—bypass pathways of blood flow, which development is typical for patients with this disease. Based on an analysis of all the circumstances, we decided to perform the intervention laparoscopically, without extensive incisions, through small punctures in the abdomen.