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World’s Largest Chest Tumour Successfully Removed at Fortis

News Desk, News Nation 360 : In what might be termed as a medically challenging rare surgery, Dr Udgeath Dhir, Director and Head, CTVS, Fortis Memorial Research Institute along with his team of doctors successfully removed, the world’s largest chest tumour weighing 13.85 kgs from the chest of a 25-year-old young male patient. As per the available medical literature and published papers, the largest chest tumour removed till date, prior to this case was in Gujarat in 2015 weighing 9.5 kgs. Speaking about the complex surgery, Dr Udgeath Dhir, Director and Head, CTVS, Fortis Hospital, Gurugram said that the patient came to them in a very critical condition as his lungs were compressed owing to the size of the tumour in the chest due to which he was not able to carry his daily routine activities. It was 4-hour surgery that involved opening both the sides of the chest and cutting the chest bone (sternum) in between. In technical terms, they call it a clamshell incision. The tumour owing to its vast size couldn’t be removed through minimally invasive surgery and thus it was required to be cut and further enable the removal of the gigantic tumour from the patient’s chest. Throughout the procedure, maintaining adequate blood flow was critical. A lot of precision is required in such surgical procedures as the patient can even collapse if the procedure is not done with acute precision. This was a high-risk surgery owing to the bulk of the tumour which had occupied the entire chest making it difficult to operate on multiple vessels as the neck of the tumour couldn’t be controlled and the capsule of the tumour cannot be breached. Patient Devesh Sharma was presented in an extremely critical condition at Fortis Memorial Research Institute, Gurugram, with breathlessness and extreme uneasiness in the chest. He wasn’t able to sleep straight on the bed due to breathing trouble for the past 2-3 months. Upon evaluation at another hospital in the city, the pulmonologist had advised him for a chest CT scan. The scan report indicated a massive tumour in the chest which was occupying more than 90% of the chest area, engulfing the heart and displacing both lungs which led to only 10% of the lungs functioning. Devesh was suggested visiting Dr Dhir for further line of treatment by other senior doctors. In addition to the criticality of the surgery, the patient had a very rare blood group, AB negative. In cases, where patients have large tumours in the chest the administration of anaesthesia becomes critical.  As at the time of administration of anaesthesia, owing to the weight of the tumour, the heart gets compressed and it might restrict the forward flow of blood, which leads to negligible blood pressure. To avoid this situation, and mitigate any risk to the surgery, doctors had to prepare the patient under local anaesthesia for an emergency cardiac pulmonary bypass, in case required. However, the anaesthesia team had a robust preparation for the pre-operative anaesthesia administration and no complexities arose in the operative period.

Report : Anustup Kundu