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Complex cancer surgery done at Arogya hospital, Hosur
Mrs Savithri (Name changed), aged 50 yrs, from Denkanikottai, was diagnosed to have cancer cervix about a year back. She was initially treated with radiotherapy, which caused reduction in size of tumor. However, there was residual tumor, which was involving the urinary bladder and blocking the urine tubes on both sides, as well as involving the rectum. Patient was referred to Arogya hospital, Hosur in this stage. The Surgeon, after thorough examination of the patient and discussion with Gynecologist and Urologist, decided to perform a major surgery called total pelvic exenteration. Accordingly, the surgery was performed in August 2015. In this operation, the patient’s Uterus and cervix along with Urinary bladder and rectum, which were affected by cancer, were completely removed and an alternative passage for urine and stools were created. The surgery lasted for 8 hours. Patient was treated in ICU for 6 days. Patient was discharged from the Hospital after 15 days in a stable condition. Final histopathology of the removed specimen showed complete cancer clearance. After 3 months of follow up, patient is doing fine and has gained weight.
Cancer cervix is the most common cancer affecting females in India. Treatments like radiotherapy and radical surgery offer good results in these patients. Even for patients presenting with locally advanced cancers, complex surgeries like this can be performed to give good result. Total pelvic exenteration is a very complex cancer surgery usually done only in cancer institute. However, with the availability of good support system and intensive care, we are able to perform such surgeries in our hospital.
Figs: Showing implantation of ureters (Urine tubes) into sigmoid colon