A unique surgery by surgical oncologists and endoscopists at the Pirogov Clinic of SPbU

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For the first time, surgical oncologists and endoscopists at the Pirogov Clinic of High Medical Technologies at St Petersburg University (SPbU) have performed surgery to remove a malignant tumour of the oesophagus and conduct a biopsy of the lymph node.

This approach enabled doctors to perform radical surgery of the tumour endoscopically, without needing to perform surgical intervention. The procedure was similar to the well-known and common fibrogastroduodenoscopy (FGDS) and was performed under general anaesthesia.

“The doctors also had to perform additional diagnostics in order to find whether cancer cells break away from where they first formed and to prevent future relapses. For that reason, we performed a sentinel lymph node biopsy,” said Rostislav Pavlov, an oncologist and Deputy Director for Medicine (Oncology) at the St Petersburg University’s Pirogov Clinic.

The doctors at the St Petersburg University’s Pirogov Clinic examined the sentinel lymph node. The sentinel lymph node is the organ that can evidence first that cancer cells from the tumour have begun to travel through the body. Medical technologies we have today enable us to find easily this lymph node.

During the endoscopic stage of the surgery, the doctors injected a fluorescent substance into the tumour. Through the lymphatic vessels, it entered the nearest lymph nodes creating a green glow. This highlighted signalling node had to be removed and checked for cancer cells.

Laparoscopy was used to take biopsy samples. It is a minimally invasive approach to modern surgery on internal organs through small openings, avoiding large incisions and noticeable sutures. This results in reducing to a minimum what has to be done during the surgery and lessens patient’s pain in the postoperative period. Additionally, this can reduce the recovery phase that usually takes long after abdominal surgery.

“The surgery was successful. We removed the tumour and performed a full diagnostics minimising the risk of recurrence. We discharged the patient on the third day after the intervention,” said Rostislav Pavlov.