THANKS TO ADVANCED TECHNOLOGIES, DOCTORS AT THE NATIONAL MEDICAL RESEARCH RADIOLOGICAL CENTRE SAVE PATIENTS WITH RARE DISEASES

The story of our patient Alena seemed ordinary at first glance – her appendix became inflamed. She immediately sought help at her local medical facility. But just six months later, she was lying on the operating table at the P. Hertsen Moscow Oncology Research Institute, and the surgeons were checking off a 15-point operation plan. This procedure, scientifically known as cytoreduction, involved removing many organs located in the abdominal cavity affected by the tumor process: part of the peritoneum, the right and left diaphragmatic domes, the pelvic organs (the uterus with its appendages and the omentum), the gallbladder, the spleen, and the right and left flanking channels. And that was just the first, albeit very extensive, stage of the operation. The surgeons also had to perform a session of intraperitoneal hyperthermic chemotherapy (HIPEC) in the same operating room.

“Our patient has a very rare disease – pseudomyxoma peritonei. It accounts for one percent of all gastrointestinal cancers. It is a consequence of mucinosis development in the vermiform appendix, or simply put, the appendix. At some point, mucus called mucin begins to accumulate there, gradually filling the entire abdominal cavity, and the tumor compresses the nearby organs and invades them,” explains the operating surgeon, head of the abdominal surgery department, Candidate of Medical Sciences Sergey Poluektov. “In our case, the tumor process had already spread quite extensively and even partially affected the liver – we removed a capsulated lesion from it as well. In a certain sense, we were fortunate with the patient: the cancer cells did not reach the rectum, and we were able to preserve it. This is one of the most important factors in ensuring a subsequent normal quality of life.”

“After the planned surgical intervention, we will review the completed manipulations, as it is a large operation, close the surgical incision, and create four small openings for drains that will provide adequate inflow and outflow of the chemotherapeutic agent-cytostatic in the patient’s abdominal cavity,” says Senior Researcher of the Abdominal Surgery Department at 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, Candidate of Medical Sciences Nikolai Grishin.

To conduct such a chemotherapy session, a separate team of physicists and chemists brought a special apparatus to the operating table and connected it. This apparatus heats the solution to the required temperature of 42 degrees and allows it to circulate freely in the abdominal cavity for an hour.

“Our institute has accumulated extensive experience with such surgical interventions, but intraperitoneal chemotherapy has only recently entered our practice,” emphasizes Academician of the Russian Academy of Sciences Andrey Kaprin, General Director of the National Medical Research Radiological Centre of the Ministry of Health of the Russian Federation. “The latest methods, such as HIPEC and PIPAC, which were introduced into our clinics as part of the ‘Healthcare’ national project, significantly enhance the effectiveness of surgical treatments and allow us to extend the lives of patients whom oncologists could not help before.”

The operation went smoothly. At home, Alena’s two children are waiting for her and are eager for their mother to return to them soon. So let’s wish our heroine a speedy recovery and good health!