Mysuru: Woman detected with ovarian cancer was successfully treated by doctors of JSS hospital with modern Cytoreductive surgery-Hyperthermic Intra-peritoneal chemotherapy (CRS+HIPEC).
A 44-year-old lady was detected to have large ovarian tumor in December 2015. She was operated at a private nursing home but found to have extensive disease that could not be removed. She developed life-threatening complications and came to JSS Hospital in a critical condition. After being stabilised by the cardiology team, she was seen by Dr N Roopesh Gynecologic Oncologist. After having a stormy period of recovery during 1 month of hospitalisation, she recovered from the complications & got discharged. She received 4 cycles of Neoadjuvant chemotherapy (to shrink the size of the tumor) and after adequate response, planned for CRS+HIPEC.
Patient being a Railways health scheme beneficiary, after all necessary approvals, was admitted on June16. A thorough pre-operative assessment was made and after all necessary investigations she was taken to the operation theatre on June 18 at around 8.45 a.m. The team of anesthesia (headed by Dr.Nalini & team) then performed requisite procedures such as Epidural catheter insertion, arterial cannulation, central venous access and administration of general anesthesia. Dr N Roopesh (Gynecologic Oncologist) started the surgery at 11 am. A thorough staging was done and complete extent of the disease was noted. In view of previous surgical intervention and associated post-operative complications she was found to have densely adhered disease at various sites within the abdominal cavity. Widespread small volume dissemination of the disease was also noted. All macroscopic disease was removed (including ovarian tumor on both sides, uterus, omentum, pelvic & para-aortic lymph nodes, multiple peritoneal deposits). A portion of the large bowel was also removed (to achieve clearance) and re-joined (after HIPEC) with the help of Dr.Ravi, Surgical Oncologist. Then by around 10 p.m., HIPEC procedure (heating up of Chemotherapy drug to 42 degrees and circulating it within abdominal cavity) was performed for 60 minutes.
This advanced procedure was carried out with the help of an exclusive machine, dedicated for such procedures, which were rented out from Bengaluru. The marathon surgery lasted for a period of 15 hours and got over by 2 a.m. ( June 19). Patient tolerated the entire procedure well. She was later managed in SICU by Dr. Shyamsunder (Intensivist) and team. She was shifted to ward on 5th post-operative day. She was discharged in a stable & healthy condition on June 28” added Dr Roopesh.
