Surgical treatment of large neoplasms with the involvement of several organs or entire organ complexes in the pathological process is a serious challenge for any oncologist due to its high complexity and significant risks. The University Clinic of Odesa National Medical University is a center for providing assistance to patients who could not be treated in most medical institutions. Highly qualified specialists as part of multidisciplinary teams are daily searching for optimal ways to solve clinical tasks of increased complexity.
A patient came to the University Clinic of Odesa National Medical University with complaints of an increase in the size of the abdomen during the year and general weakness. According to research data, a large tumor was found, localized in the abdominal cavity and pelvis. In February 2022, the patient underwent an examination in the city’s medical facilities, as a result of which it was established that the tumor was of intestinal origin with damage to the ovaries. After completing 5 courses of polychemotherapy, the dynamics was negative due to an increase in the size of the neoplasm to the conditional 196x215x290 mm with displacement of the intestinal loops, compression of the urinary system and impaired kidney function. According to the results of a comprehensive examination, a diagnosis was established: Cr of the ascending part of the colon with giant mts in the ovaries.
Condition after 5 courses of neoadjuvant polychemotherapy: negative dynamics due to an increase in neoplasms; tumor compression of both ureters; mild anemia.
A team consisting of clinical oncologists, oncogynecologists, oncourologists, anesthesiologists and cardiologists was involved in the treatment. After a careful analysis of the clinical situation, in view of the progression of the disease with impaired function of organs of several systems and the lack of response to previous treatment, a decision was made regarding the expediency of surgical intervention in order to remove the tumor and restore the impaired functions to an adequate and sufficient extent.
The surgical team consisted of: Vyacheslav Maksimovskii (Ph.D., Head of the Department of Surgical Profiles, Associate Professor of the Department of Radiodiagnostics, Therapy, Radiation Medicine and Oncology), Roman Chistyakov (oncologist, urologist-surgeon of the highest category, assistant of the Department of Radiodiagnostics , therapy, radiation medicine and oncology), Valeriya Varbanets (surgeon, urologist, assistant of the Department of Surgery #3), Oleksandr Duzenko (anesthesiologist) – performed a multi-stage intervention including: cystoscopy, catheterization of both ureters; cytoreduction, extirpation of the uterus with appendages, right-sided hemicolectomy; ureterolysis.
The operation lasted for 6 hours and ended according to the planned volume. No complications were observed in the postoperative period, the patient fully recovered her ability to self-care, the impaired organ functions began to improve.
Today, thanks to the highly qualified specialists who constantly improve their knowledge and skills, as well as the technical equipment that corresponds to the level of the world’s highly specialized centers, the ONMedU University Clinic has the opportunity to reproduce in practice an individual approach to each patient with complex manifestations of oncological diseases.