This is a very difficult operation, during which a liver tumor is first removed, and then a tumor thrombus using artificial blood circulation.
The UMC team encountered an unusual clinical case while treating a small patient. At the beginning of the year, a 1.5–year-old girl was hospitalized at the UMC Maternity and Childhood Center with hepatoblastoma of the right lobe of the liver, a highly malignant tumor that occurs in young children. The results of computer and magnetic resonance imaging showed a large formation that spread into the cavity of the right atrium.
The multidisciplinary council decided to start treatment with courses of polychemotherapy. According to clinical protocols, this therapy tactic helps to significantly reduce the size of the tumor, which further makes it possible to perform surgery more safely. After 4 courses of chemotherapy, the child's condition indicators improved markedly, the tumor decreased by more than 2 times. However, the removal of the tumor was still complicated by the presence of a blood clot at the mouth of the inferior vena cava, at the very entrance to the heart.
Then the team decided to use an artificial blood circulation device with the participation of cardiac surgeons at the UMC Heart Center. The device is often used in open heart surgery as a way to replace its function to maintain continuous blood circulation. During an 8-hour operation, doctors removed a malignant liver tumor, after which a blood clot was removed in conditions of artificial circulation and an open heart. The resulting defect of the inferior vena cava was also plasticized with a patch from its own pericardium. The duration of use of the cardiopulmonary bypass machine was 117 minutes. The child's condition is stable, the girl was discharged home.
It is worth noting that the artificial blood circulation device was used for the first time at the UMC Maternity and Childhood Center. Previously, newborn patients with congenital heart diseases were referred for surgical treatment at the UMC Heart Center.
This operation was successfully performed by specialists from UMC clinics: Yuri Pya, Chairman of the UMC Board, cardiac surgeon Galymzhan Utegenov, pediatric surgeons Dulat Mustafinov, Dastan Rustemov, Ruslan Utebaliev, pediatric anesthesiologists Talgat Ibraev, Gulmira Zhauarova, perfusiologist Linar Faizov, operating nurses Maral Shardenova, Raushan Smailova and Anastasia Bayandina. Also, a significant contribution to the treatment and preparation for the operation of a small patient was made by the team of oncologists and the attending physician Kamaliddin Omirzakh.
A well-coordinated team and the combined efforts of various specialists have shown an example of successful integration of UMC clinics. In the future, patients will be able to receive high-quality medical care from the multidisciplinary UMC team.