P. Hertsen Moscow Oncology Research Institute removed a giant tumor

A patient with a giant non-organ retroperitoneal tumor was successfully operated on in the thoracoabdminal department of the P.A. Getsen Moscow State Medical Institute by a team of surgeons under the leadership of Andrey Ryabov, Deputy Director General for Surgery of the FSBI “NMIC Radiology” of the Ministry of Health of the Russian Federation.

The patient himself came to the polyclinic for a consultation, after they could not diagnose him at his place of residence. In the shortest possible time, he underwent all the necessary diagnostic procedures and was diagnosed with liposarcoma. This disease belongs to rare types of malignant neoplasms, which are characterized by rapid growth and a high degree of aggressiveness. The tumor weighing about 20 kilograms occupied almost the entire abdominal cavity of the patient and squeezed neighboring organs.
The operation lasted about three hours, the patient had a malignant neoplasm and a tumor thrombus removed from the inferior vena cava. The leading surgeon of this operation, Ph.D. Ilya Kolobaev noted that the surgical intervention as part of the team of doctors Farhad Vindizai and Alexander Kamalov took place in the normal mode using the blood-saving device Cell Saver and lasted a little more than three hours. Despite the large size of the tumor, which occupies the entire abdominal cavity, the team of surgeons managed to perform a radical operation and preserve all adjacent neighboring organs. Due to surgical treatment, a non-organ retroperitoneal tumor weighing more than 20 kilograms and a thrombus of the infrarenal segment of the NSAID were removed.

The course of the operation: during the revision, the entire abdominal cavity is occupied by multiple tumor nodes of various sizes, soft consistency, slightly mobile arcuate squeezing and pushing adjacent organs to the left, the laparotomy incision was supplemented with a Mercedes-type incision, partial parietoviscerolysis was performed by acute and bi- and monopolar coagulation. Due to the low mobility of a single tumor conglomerate, it was decided to first remove the tumor node located in the right lateral canal. The tumor node is partially acute, partially blunt circularly mobilized and removed. In the left part of the abdominal cavity, there is a tumor node spreading from the left dome of the diaphragm, intimately adjacent to the right kidney, spreading through the lateral canal into the pelvic cavity. Taking into account the prevalence of the pathological process, the involvement of the above anatomical structures in the operating room, a blood-saving Cell Saver device is deployed. Partially acute, partially blunt, the mobilization of the tumor node from the left iliac region was initiated, the node was mobilized to the external iliac artery, at the stage of mobilization, the right ureter was visualized and traced. The mobilization of the tumor node from the left subcostal region has begun, the intimate diligence of the tumor node with a horizontal branch of 12pc is noted, the 12pc was separated from the tumor node by an acute way. The right kidney is circularly isolated from the thickness of the tumor node. The right ureter is also isolated from the thickness of the node and skeletonized to the point of confluence with the bladder, the ureter is visually viable, expanded, peristalting. The tumor node is circularly mobilized and removed. During further revision, deformation of the infrarenal segment of the inferior vena cava is noted, the IV is clamped below the level of the confluence of the renal vessels, the wall of the IV is longitudinally dissected, parietal thrombotic masses are removed from the lumen, the defect of the wall of the IV is sutured with a wound suture.

On the ninth day after the operation, the patient was discharged home in a satisfactory condition.

Press Service of the Federal State Budgetary Institution “NMIC of Radiology” of the Ministry of Health of Russia