Stomach tumor in 92-year-old patient successfully removed at National Medical Research Radiological Centre
It all started with a stomach ulcer. Maria Nikitichna began to feel heaviness after eating, pain, weakness. And without thinking twice, she went to the doctor. She was examined and diagnosed with an ulcer of the stomach and duodenum, and treatment was prescribed. Pills, diet, medical supervision. After the end of the course, as expected, the patient came for a second endoscopy, which showed that the ulcer had healed in the duodenum, but in the lower – antrum – section of the stomach the ulcer had grown in size. A biopsy from the affected area left no doubts: a signet ring cell carcinoma was found in the mucosa.
The tumor had already penetrated into the muscle layer, and it was impossible to remove it by a sparing endoscopic method. But the doctors did not dare to perform a major operation. The fact is that the patient is already 92 years old. Chronic kidney disease, diabetes mellitus, excess thyroid hormones that make life difficult, and in addition – angina pectoris. Here you already have to choose what is more important and what is more difficult. However, it is not in vain that many experienced doctors do not get tired of repeating: attitude is important in our business. If the patient is at the same time with the doctor, the disease is “in the minority”.
At first doctors didn’t consider the nature of the patient: she has worked for many years in the North, which hardens not only the body, but also the character. The patient did not give up and insisted on radical treatment. And then the regional doctors made the only right decision: after a teleconsultation with the National Medical Research Radiological Centre, the patient went to Moscow.
“After a closer analysis, we perfectly understood the complexity of this situation,” says 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. “And it wasn’t just about age. Even minor postoperative complication could be fatal for the patient. But for several years, such a direction as perioperative support and patient preparation has been intensively developing in our center. The institute staff includes cardiologists, neuropathologists, endocrinologists, nephrologists, rehabilitation specialists, and, of course, experienced anesthesiologists-resuscitators. This makes it possible to take seriously ill patients to us and prepare them for the most difficult operations. And our patient from Nadym is just such a case.
It is clear that before taking such a responsible step, doctors talk in detail with the patient, explaining all the risks. But Maria Nikitichna insisted on her decision: we will do the operation!
“During the operation, we removed most of the stomach affected by the tumor and formed two anastomoses, connecting the rest of the stomach and the small intestine in the right place,” says the head of the thoracoabdominal department, Ph.D. Vladimir Khomiakov. — The postoperative period passed without complications.
After surgery X-ray control showed that the contrast agent freely enters the small intestine from the stomach through the anastomosis. The evacuation of the contents of the stomach proceeds without delay. After 10 days, the patient was successfully discharged from the hospital.
Of course, the operation is not everything. Comprehensive accompanying therapy and, the expanding of patient’s diet and activity continues. After discharge – a whole list of recommendations on how to behave, how to eat, what to pay attention on. And necessarily control studies – every three months in the first year. But already on the third day after the operation, the patient agreed to say a few words to us.
“We need to be really grateful for doctors like this,” says Maria Nikitichna, smiling. I woke up a different person. No burping, no pain. This is just a miracle! What wonderful people work here! And many thanks to everyone who prepared me for the operation, and who operated, and to my attending physician. Everyone is so attentive, sensitive, I’m really glad with all my heart that I was led here, at the P. Hertsen Institute. Keep living!
The story of one of the oldest and most positive patients became known throughout the institute, and on the day she was discharged, many people told us – she won, did you hear?
Press Service of National Medical Research Radiological Centre of the Ministry of Health of the Russian Federation