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ANDREY KAPRIN: " BE HEALTHY - THIS IS THE BIGGEST REWARD FOR US"

A unique operation, performed on October 6, 2020 at the Botkin Hospital by an interdisciplinary team of doctors from P.Hertsen Moscow Oncology Research Institute and the Botkin City Clinical Hospital, was completed successfully: today the patient is preparing for discharge.

“How can I ever thank the doctors?” the rescued patient from Karachay-Cherkessia asks. - After all, you gave me a second life.

- Be healthy, - Academician of the Russian Academy of Sciences Andrey Kaprin says, - for us, doctors, this is the greatest award.

One and a half years ago the patient underwent surgery for a tumor in the right kidney. This summer, the patient’s condition deteriorated.

After examination, local doctors confirmed a relapse of the disease: the tumor of the right kidney had developed into a huge tumor thrombus. It started from the affected kidney, filled the inferior vena cava, hepatic veins and heart cavities, disrupting the flow and outflow of blood from the heart.

 

The drama of the situation was that, despite a healthy heart, the patient was dying of heart failure. The woman was denied in several Russian and European clinics and was hospitalized only at P.Hertsen Moscow Scientific Oncology Research Institute.

     Considering that the patient was diagnosed with damage to the kidney, inferior vena cava, hepatic veins, vessels of the lower extremities and heart, it became obvious that it would be possible to try to save a woman only by combining the potential of two leading clinics in Moscow and Russia – P.Hertsen MORI and the Botkin Hospital. Dr. Alexey Shabunin , the Chief Physician of the Botkin Hospital, a brilliant surgeon and Corresponding Member of the Russian Academy of Sciences, immediately responded to the proposal of his colleagues to conduct a joint operation.

Specialists of the two clinics held a joint consultation, formed a surgical team, which included oncourologists, vascular surgeons, cardiac surgeons, abdominal surgeons, surgeons - hematologists, anesthesiologists and perfusionists of the highest level.

Oncourologists and abdominal oncological surgeons were the first to start the operation, isolating the affected kidney from the adhesions, all the main vessels of the abdominal and retroperitoneal organs. Then, after the removal of the kidney, the work was continued by the cardiac surgeons. At this stage, a heart-lung bypass machine was connected, which, replacing the work of the heart, allowed doctors to open it and completely remove the thrombus from the right atrium.

      During surgery, there was a danger that the thrombus or part of it would break off, which would entail irreversible consequences for the patient's health. If at least one fragment of this huge thrombus came off or one cancer cell and flew away along the vascular bed, the patient would have received the most severe life-threatening complications - heart attack or stroke. Therefore, the surgical intervention was performed with the utmost precautions.

Only after vascular isolation was the kidney removed and a heart-lung bypass machine was connected, the myocardium was dissected, the heart was opened, and the thrombus and its parts were sequentially removed from the right atrium, hepatic veins, vessels of the lower extremities and the inferior vena cava.

     This was followed by the stage of precise restoration of the myocardium and all vessels, after which cardiac activity was restored and the heart-lung bypass machine was switched off. The operation lasted 8 hours.

      Today, three weeks later, the patient is doing well and is going home. Before discharge, both leaders, Academician Andrey Kaprin and Dr.Alexey Shabunin, came to visit her.

- Surgeons consider an operation successful when the patient has fast recovery and can do everything on his own - Academician Kaprin says - this is a really good result.

   The patient will rest for three months and gain strength, then the oncologists will call her for a control check and, basing on the results, will recommend further tactics.

- The operation was carried out at the highest professional level - Academician Kaprin said - we managed to remove a very unusual tumor in the form of a huge thrombus in one piece, without destroying the structure, so we really hope for a further positive prognosis.

NMRRC Press Service

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