The 77-year-old patient visited National Center of Surgery.
The patient was suffering from the following symptoms:
- Dull and constant pain in the anal area;
- Blood discharge from anus following defecation and without it;
- General weakness;
- Rectal tenesmus ( desire for false defecation);
- Unreasonable weight loss;
- Bloated abdomen
- Constant constipation;
- Nausea, especially after consuming food high in fat.
He’s been suffering from these symptoms over the past few months.
It should be noted that in 2018 , in National Center of Surgery colonoscopy was performed on the patient, where large growth with serrated surface and uneven edges was detected 4-5 cm from the anal sphincter (biopsy was performed), whereas, polyps were detected in sigmoid colon (large intestine).
Additionally performed abdominal computed tomography and lesser pelvic cavity magnetic resonance imaging showed stones in the gallbladder.
As the head of the proctologic department at the National Center for Surgery, surgical-oncologist Lasha Silagava stated in an interview with us, with the rectum’s histomorphological examination following were diagnosed: the high density of adenocarcinoma G1 and the adenomatous polyps in sigmoid colon.
Diagnosis:
With the examination followings were diagnosed:
1. Malignant rectal cancer T3N1M0 IIIst, II cl//group;
2. Large intestine (sigmoid colon) polyps.
3. Chronic calculous cholecystitis.
Doctors from every medical profile in one space!
As you may know, the National Center of Surgery is a multi-profile clinic. Therefore, patient is attended by doctors from various medical profiles in one area. Based on the diagnosis, the patient's health condition management required a multidisciplinary approach.
In the department of Radiotherapy, at the onco-council (National Center of Surgery’s TUMOR BORD that consists of surgical oncologist, clinical oncologist, radiation oncologist, and invited radiation therapy experts from U.S and Spain) clinical oncologist, radiation therapist and surgical oncologist conjointly planned first stages: lesser pelvic cavity magnetic resonance imagining and abdominal computed tomography.
Chemotherapy and Radiation therapy.
For the patient, clinic’s oncologists appointed a full course of chemo and radiation therapy, that was performed using IMRT arc techniques for the growth in a rectal area and mezorectum and regional lymph nodes with a daily dose of 1,8 grams, 26 fractions, total of 46,8 grams. Magnetic resonance imaging showed the infestation in perirectal and mesorectal fat tissue. Signs of infestation and metastases were not detected in other organs.
Surgical operation using laparoscopy method
Surgeon states – "Subsequent to chemotherapy and radiation therapy, growth in a rectum significantly decreased in dimensions. Patient was relieved from the pain in anal area and has improved defecation. After proper preparation, under the general anesthesia simultaneous (combined) operation, abdominoperineal resection (Miles’ operation), left hemicolectomy and laparoscopic cholecystectomy were performed. The head of the department of surgery, Gigo Pichkhaia and surgeon Beso Lursmanashvili also participated in the surgical operation.
It should be note that the postoperative period proceeded without any complications. The patient was discharged on the 5th day with a satisfactory health condition.
National Center of Surgery address: Tbilisi, Dighomi, Chachava N5.
You may contact National Center of Surgery’s call center at 577 119 119 or 2 02 25 25
Wish you health!
