SURGICAL PRECISION: HOW TO SAVE A KIDNEY IN A CRITICAL SITUATION

To every patient who crosses the threshold of our Centre, we strive to give the most important thing – hope. Sometimes, oncologists in our departments meet not just patients, but stories. Stories of struggle, doubts, delays, hopes, and, finally, the determination to trust us. One such case was the story of a resident of the Yamalo-Nenets Autonomous Okrug, who, together with our doctors, was able to defeat his illness and reclaim his chance at a full life.

Alexander is 69 years old. Twenty years ago, he underwent a nephrectomy due to renal cell carcinoma: a 5-centimeter tumor was removed along with the affected kidney. For all these years, the man diligently monitored his health, undergoing check-ups every six months. Everything changed in 2022. A new tumor, just 2 centimeters in size, was discovered on his remaining kidney. It seemed that time was on his side.

However, instead of seeking treatment, he decided to wait. With Tibetan medicine practices, meditation, and intermittent fasting, Alexander searched for his own ways, hoping the disease would disappear on its own. But the tumor continued to grow. By the time he finally turned to doctors, its size had reached 42 millimeters.

At this point, local specialists understood the situation was critical. Any further delay could result in the loss of function of the only remaining organ. Just a little longer, and Alexander’s life would have been dependent on dialysis.

The man was fortunate – he came under the care of the oncology urology team at the P. Hertsen Moscow Oncology Research Institute, a branch of the National Medical Research Radiological Centre of the Ministry of Health of the Russian Federation. Their task was nearly impossible: to remove the tumor while preserving the single organ upon which his entire life depended.

This work required surgical precision. “Usually, when removing a tumor, we clamp the blood vessels to avoid bleeding. But in this case, it was not an option. Any interruption of blood supply could lead to irreversible changes,” explains Head of Department Alexey Krasheninnikov. “The kidney is an organ rich in blood vessels. Clamping them can result in what’s called anoxia – a lack of oxygen, which is critical for the organ’s function.”

In this case, the surgeons’ task was to remove the tumor while minimally damaging the tissues and preserving the organ’s function. The operation lasted an hour and a half. “We used a laparoscopic method: through small punctures, we removed the tumor using a bipolar instrument, which allows us to cauterize small blood vessels and minimize blood loss. 100 milliliters of blood – that was the cost of the operation, which we performed without clamping the vessels,” adds Alexander’s attending physician, Fidan Samedli.

The primary victory was preserving the kidney’s functionality. Already in the intensive care unit, the patient’s urine output confirmed the success of the intervention. “We managed to maintain the patient’s quality of life. His kidney is fully functional, and further monitoring will allow us to minimize the risk of recurrence,” summarized Fidan Samirovna.