25 March 2008

All organs removed in op on tumour

Brooke Zepp was diagnosed a rare cancerous tumour and given six months to live. But surgeons performed what's believed to be the first operation of its kind and saved her life.

Brooke Zepp, a 63-year-old South Florida woman, was diagnosed last May with leiomyosarcoma, a rare cancerous tumour deep inside her abdomen that had wrapped itself around her aorta and other arteries that supply blood to vital organs such as the stomach, intestines and spleen.

Surgery wasn't an option, she was told, because there was literally no room to remove the tumour without damaging those vital organs. She was given six months to live.

Refusing to give up, Zepp went to the University of Miami/Jackson Memorial Medical Centre, where surgeons at The Transplant Institute performed what's believed to be the first operation of its kind.

Early this month, they removed six of her internal organs, freeing up space to cut out the cancer, and then they reinserted the organs.

All the organs removed during op
Usually, this is an inoperable tumour, Dr Andreas Tzakis, director of The Transplant Institute, said. "In order to remove the tumour, we took a very unusual approach. We removed all the organs along with the blood vessels and the tumour," he said.

Before undergoing the operation, Zepp had tried chemotherapy and radiation, both of which failed. The only option left was surgery, "but no one wanted to operate," Zepp said. "Because people wouldn't operate and I wanted to live, I said, 'Somebody has to do it first.'

"And I wanted to prove to people, even though many doctors told me not to do this, that I thought it would be better to take a chance on living than on dying."

The organs removed during the 15-hour surgery were the stomach, pancreas, liver, spleen, small intestine and about two-thirds of the large intestine. Because of their delicate nature, the kidneys weren't taken out during the procedure, Tzakis noted.

Organs kept chilled while tumour removed
"We had to move very quickly because the organs were removed from her body and she had no organs in the belly. And we had to move quickly to cut the tumour out," Tzakis said.

Once the tumour had been removed, Zepp's organs - which had been kept chilled - were placed back in her abdominal cavity and artificial blood vessels were put in and connected. In total, the organs were outside her body for about 90 minutes, Tzakis said.

He said the idea for the surgery was a natural extension of the work his team had been doing with multiple organ transplants.

"This is unique and brand-new, but pieces of the surgery were done before," Tzakis said. "We know how to remove organs - we know how to put them in. We've done surgery to remove liver tumours, taking the liver out of the body, removing the tumour and putting the liver back in."

The Miami doctors have also performed similar operations removing tumours from intestines, Tzakis said. "So this came to us kind of naturally. We've done pieces, we just hadn't done the entire thing at one time," he added.

Zepp said she feels good. "I feel like I'm coming through a tunnel and I have a whole life ahead of me," she said, and added, "I want the rest of the world to know that inoperable cancers can be operated on. Different cancer centres have different training and their own vision, and they don't think in the terms that a transplant surgeon would." – (HealthDay News)

March 2008

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