New possibilities in surgery at Lviv Cancer Treatment Centre

The development of science and new methods of combating cancer make it possible to achieve full recovery of many patients; nevertheless, the main principle of treatment remains unchanged: maximum removal of tumor tissue. The role of surgery for cancer cannot be overestimated, because this is the only way to get rid of the tumor itself, as well as of the negative impact that it has on the affected organ.

 

For the sake of efficient clinical outcome and maximum psychological comfort associated with postoperative rehabilitation, improvement of approaches to surgical interventions is constantly underway. Modern science has proven the positive effect of organ preserving surgeries, and their methods are being constantly improved.

 

The most effective reconstructive surgeries especially in oncology are surgeries using the tissue of a patient, since while using alien implants there is a risk of rejection.

 

Currently, surgeons in the world widely use the method of free tissue transplantation in many sections of surgery: plastic surgery, oncology, orthopedics and traumatology, neurosurgery, urology, gynecology etc.

 

Free transplantation of flaps with application of microvascular anastomosis makes it possible to carry out one-time transplantation of large cutaneous flaps with subcutaneous fat; it radically changes the idea regarding the possibility of clinical effect and plastic surgery with one single operation, which significantly reduces the time for rehabilitation of patients. Free tissue transplantation using microsurgical techniques is a reliable method of reconstructive surgery.

 

Successfull carrying out of microsurgical operations requires the use of a surgical microscope, of a special toolkit, and of the suture material.

 

On May 4, 2017, the first reconstructive surgery with application of the vascular microanastomosis was held in the Lviv Regional State Cancer Treatment and Diagnostics Centre.

 

A patient named K., 55 years old, was diagnosed with cancer of the left tonsil of the second stage. His condition after radiotherapy is relapse. The tumour recovered in spite of the held treatment, which indicates a biologically aggressive course of the disease.

 

A surgery was held: removal of the oropharyngeal tumor with resection of the upper and lower jaws; selective lymph node neck dissection of the I, II, and V levels; plastic of the defect by radial cutaneous and fascial forearm flap with application of vascular microanastomosis.

 

Today (the 6th day after the surgery) the patient is in the postoperative period without any complications, the drains were removed.

 

Carrying out of such operations in the Lviv State Cancer Treatment and Diagnostics Centre was made possible through the "Preventive oncology and the implementation of effective anti-tumour technologies in Lviv oblast" Subproject, as in addition to the screening and diagnostics equipment, surgical devices were procured in the framework of the subproject, in particular operating tables "SCHMITZ" (Germany), LED surgical lamps, and a surgical microscope "Carl Zeiss" (Germany).

 

It should also be noted that the subproject supports the introduction of modern treatment and diagnostics technologies not only through equipment. Of great importance is training held abroad at leading hospitals and institutions in Europe, particularly in the oncology hospital in the city of Heidelberg (Germany), where such reconstructive surgeries are performed on a daily basis in each department (each operating theater is equipped with a microscope).