Rare extensive supra major surgery performed at Aditya Birla Memorial Hospital. It is one of the rare surgeries performed which involved clinical psychologist, stoma care expert, and physiotherapist.
Aditya Birla Memorial Hospital, Pune’s 1st JCI and NABH accredited hospital has successfully performed a rare surgery on a 58-year-old woman with advance stage 4A cervical cancer involving urinary bladder. Sonal (name changed), 58 year old woman with post menopausal bleeding , was referred to our Dr. Nikhil Parvate, Consultant gynae oncologist in view of suspicion of cancer cervix. Patient underwent complete diagnostic work up including CT, EUA ,BIOPSY and a diagnostic laparoscopy.
After all meticulous work up it was found out that the patient had a very advanced stage 4A cancer of the cervix involving her urinary bladder while surprisingly rest of her abdomen and pelvis were normal. This was not the natural history of spread of cancer cervix, and hence the case was discussed in the tumor board, where even the Dr. Anand Dhraskar, consultant, urology and Dr. Prakash Valse G.I. surgeon participated and lot of thinking and discussion took place .
At the end it was concluded that patient should be given the option of anterior pelvic exenteration with ileal conduit with permanent urostoma, versus concurrent CT+ RT and the problems, especially fistulas which were of high chance in this case and its future course.
Patient and relatives were explained about all this discussion and they were given time to think and decide and were also advised to take second opinion. After 10 days multiple rounds of discussion (which involved clinical psychologist, stoma care expert, and physiotherapist) it was finally decided by patient and relative to undergo surgery.
Necessary consent, documentation was done as it was going to be one of the rare surgeries performed with team of gynaec onco surgeon, urologist, G.I. surgeon and a very highly specialized anesthesia team. The surgery went on for 8 hours. Front side pelvic surgery was done where the urinary bladder was removed along with all lymph nodes and fat from the compartment which contains stomach, spleen & liver. Permanent artificial opening of urinary drainage was created and the desired result was achieved. Every member of the operating and non-operating team visited the patient daily and with stringent post-care, involving the patient and her relatives in every aspect, the patient was made fit to go home after 7 days. It was ensured that the patient was self-dependent and could do activities of daily living by herself along with taking care of the opening (stoma).
“It was a big relief for everyone involved in patient care. We were very happy to see a smile on the patient and relatives face after those tough counseling sessions and surgery. It was a great achievement for our hospital and all the doctors involved to save patients life and relieve her from pain”, shared Ms Rekha Dubey, CEO, Aditya Birla Memorial Hospital. “I was very scared when I heard I have Stage 4A cancer. It was stressful for me and my family. I was worried that now my life will be full of Chemo pain, losing my hair and the stress of it all to my family. I am really thankful to the doctors of Aditya Birla Memorial Hospital to be patient with me and help me through these difficult times”, shared Sonal, the patient.
