Saving the life of a kidney cancer patient whose tumor had spread to the heart

SGGPO 05/31/2023 15:44

If not operated on promptly, the patient is at risk of death within a few days when the tumor blocks the blood flow to the heart or causes pulmonary embolism.

On May 31, Binh Dan Hospital announced that it had just held an inter-hospital consultation with the Ho Chi Minh City Heart Institute to perform surgery to save the life of Mr. PHP (64 years old) who had left kidney cancer with a tumor spreading into the vena cava, close to the right atrium.

If not operated on promptly, the patient is at risk of death within a few days when the tumor causes blockage of blood flow to the heart or pulmonary embolism on the basis of diabetes and coronary atherosclerosis.

According to the patient's family, Mr. PHP had symptoms of bright red blood in the urine with blood clots, so he went to the doctor and discovered a tumor in his left kidney. At Binh Dan Hospital, through MSCT-scan, doctors discovered that he had a left kidney tumor measuring 68x49mm that had invaded the surrounding fatty tissue. It is worth noting that this tumor had a bud spreading into the vena cava, approaching the right atrium.

Saving the life of a kidney cancer patient whose tumor had spread to the heart, photo 1

Doctors are performing surgery on the patient.

Surgery is the only way to save the patient's life before the tumor invades the heart or embolizes the pulmonary artery. The surgery also requires the support of an extracorporeal circulation system to control and isolate the heart, preventing blood from flowing back to the vein being operated on.

In addition, the surgery was challenging because the patient had complex underlying medical conditions including atherosclerosis and coronary artery stenosis. After a cardiovascular consultation, doctors estimated the risk of myocardial infarction during and after surgery at about 80%, and the risk of death at up to 90%.

The Scientific Council of Binh Dan Hospital was convened under the chairmanship of the Hospital Director to plan in detail the surgery with the highest probability of success. The surgery has a 10-20% chance of saving the patient by simultaneously controlling many complex pathological problems and the smooth coordination of surgical teams from the departments: cardiovascular, urology, hepatobiliary, anesthesia and resuscitation.

According to Dr. Ho Khanh Duc, Head of the Department of Cardiovascular Surgery, Binh Dan Hospital, the surgery lasted about 6 hours, the total time of extracorporeal circulation was 60 minutes; the time to open the atrium and vena cava to remove the tumor bud was about 20 minutes.

After surgery, doctors ensure the patient's hemodynamics, remove the entire tumor, ensure the treatment principles of kidney cancer, and prevent the tumor from traveling to the heart and blocking the pulmonary artery. At the same time, the patient does not lose a large amount of blood.

“This was a difficult surgery, with complex underlying pathologies and a mortality rate of up to 90%. With the determination of the team and the maximum coordination of specialists, the surgery was successful. On the first postoperative day, the patient was able to remove the endotracheal tube, breathe on his own, and his vital signs were stable and he was discharged on the 7th postoperative day,” informed Dr. Ho Khanh Duc.

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