Jaw tumour removed by unique surgery

 Jaw tumour removed by unique surgery

For the first time in Russia, a unique procedure was performed on a patient with an upper jaw tumour.

Doctors from Sechenov University’s Clinic of Oncology, Reconstructive Plastic Surgery, and Radiology applied the isolated chemoperfusion method — which is normally only used for tumours of the extremities, liver, lungs, and abdominal cavity.

In this chemotherapy approach, it is possible to deliver a maximum drug dose directly to the tumour over a certain range of time and provide chemoperfusion in a closed-loop mode without affecting the general blood flow.

“Basically, we subjected the entire facial skeleton, facial tissues, and tumour to chemotherapy, and in this targeted variant of chemotherapy we connected to the circulatory system of the tumour,” said Vadim Cheremisov, the key surgeon in the procedure and Associate Professor of the Department of Oncology, Radiotherapy, and Reconstructive Surgery at Sechenov University. “With this method of affecting the tumour, we observe the best results. For example, no more than 20% of the drug reach the tumour after intravenous administration, while the rest is ‘washed out’ in the body. Chemoperfusion makes it possible to hit the tumour with a high drug concentration.”

During this unique operation, the doctors applied a technology similar to the cardiopulmonary bypass procedure used in cardiac surgery: the patient’s heart continued to work normally, providing blood supply to the entire body, but the face was excluded from the systemic circulation and was exposed to the drugs. The brain was not included in the perfusion circuit and remained completely safe when the tumour was exposed to the drugs.

The team of surgical oncologists needed to work with pinpoint accuracy, because the tumour was located in critical proximity to the structures of the facial skeleton, nasal cavity, ethmoid sinuses, major vessels, nerves, and the brain. Even a small mistake could have caused serious consequences, such as a stroke and severe toxic reactions.

This unique operation — carried out at Sechenov University under the supervision of Professor Igor Reshetov, Director of the Institute of Cluster Oncology — finished successfully. The patient now feels well and is preparing for the next stage of treatment.

Speaking about the future use of chemoperfusion, Professor Igor Reshetov noted the high potential of this technique. In his opinion, such operations for the treatment of head and neck cancer would be widely used in the near future.