{"id":66350,"date":"2024-11-04T10:37:57","date_gmt":"2024-11-04T08:37:57","guid":{"rendered":"https:\/\/aslimnica.lv\/?page_id=66350"},"modified":"2024-11-04T10:38:27","modified_gmt":"2024-11-04T08:38:27","slug":"east-hospital-performs-a-challenging-radical-surgical-removal-of-head-and-neck-tumor-with-successive-complex-reconstructive-surgery","status":"publish","type":"page","link":"https:\/\/aslimnica.lv\/en\/east-hospital-performs-a-challenging-radical-surgical-removal-of-head-and-neck-tumor-with-successive-complex-reconstructive-surgery\/","title":{"rendered":"East Hospital performs a challenging radical surgical removal of head and neck tumor with successive complex reconstructive surgery"},"content":{"rendered":"

A multi-disciplinary team at the Riga East Clinical University Hospital (East Hospital) performed a challenging radical surgery on a 43-year-old patient to remove a head and neck tumor, which was the last viable option to halt the spread of malignant cells. Subsequently, the oncology patient became the first one in Latvia to undergo the transplantation of three microvascular flaps. Following the successful surgery, the patient\u2019s health has improved, and he has regained strength to move forward with his life.<\/strong><\/p>\n

\"\"<\/a>This high-complexity surgery was performed by Ren\u0101rs Deksnis<\/strong>, Head of the Head and Neck Surgery Department of the Oncological Surgery Clinic at the East Hospital, together with the plastic surgeon Dr. med. J\u0101nis Zari\u0146\u0161<\/strong> as part of the East Hospital\u2019s multi-disciplinary team. The surgery lasted 13\u00a0hours. Prior to the surgery, various diagnostic tests and meticulous planning of the surgery were essential to ensure a successful outcome.<\/p>\n

\"\"<\/a><\/p>\n

About the patient: <\/strong>The 43-year-old patient sought an outpatient consultation with Ren\u0101rs Deksnis<\/strong>, complaining of a mass at the floor of the mouth and in the tongue. Under the \u2018Green Corridor\u2019 system, he underwent a series of tests, including a CT scan of the head and neck soft tissues, lungs, and abdominal cavity to rule out distant metastases. A biopsy revealed a locally advanced squamous cell carcinoma affecting several anatomical areas, such as the mandible, the floor of the mouth, the tongue, and facial tissues.<\/p>\n

Tumor metastases had already invaded the neck lymph nodes. The case was carefully reviewed by the ENT oncology council, which prescribed induction chemotherapy aimed at reducing and halting tumor growth. This approach has been used in treating oncology patients at the East Hospital since 2020.<\/p>\n

Although the metastatic lymph nodes decreased in size following chemotherapy, the tumor itself remained the same size, but its rapid growth was successfully halted. In the follow-up multi-disciplinary council review, it was decided to proceed with radical surgical treatment which involved removing more than half of the mandible, the entire floor of the mouth, nearly the entire tongue, as well as facial and chin skin in a single block, along with bilateral removal of lymph nodes in the neck. It should be noted that it was the only way to help the patient in his battle against the malignant tumor.<\/p>\n

\"\"<\/a><\/p>\n

The surgery was thoroughly planned in advance. \u00a0<\/strong>Cooperation between Dr. med. J\u0101nis Zari\u0146\u0161<\/strong> and the Baltic Biomaterials Centre of Excellence of the Riga Technical University, operating under the Institute of Stomatology, made it possible to develop a personalized cutting guide to enable anatomically precise reconstruction of the mandible.<\/p>\n

Course of the surgery:<\/strong>\u00a0 \u201cThe removal of the entire tumor and lymph nodes, along with subsequent reconstruction, presented a major challenge. We can say with certainty that a surgery of this magnitude had never been performed on a head and neck tumor patient before. The removal of tumor alone took four hours. It was immediately sent to the histology lab for examination to make sure that all malignant cells had been removed. Afterwards, we proceeded with the reconstruction of the mandible, the floor of the mouth, the tongue, and face. The surgery lasted 13\u00a0hours,\u201d explains Ren\u0101rs Deksnis<\/strong>.<\/p>\n

\u201cThis is the first time an oncology patient undergoes the transplantation of three microvascular flaps: a bone flap for mandibular reconstruction, a soft tissue flap to construct new tongue and the floor of the mouth, and a third soft tissue flap to repair a facial tissue defect. Nine vascular anastomoses were sutured to ensure the viability of the transplanted tissues. This intricate reconstruction was essential to fully restore the lost structures, allowing the patient to breathe, eat, drink, speak freely, and have a pleasant appearance in a short time,\u201d says the plastic surgeon Dr. med. J\u0101nis Zari\u0146\u0161<\/strong> with satisfaction.<\/p>\n

Despite the complicated and difficult reconstructive surgery, the post-operative period for the patient progressed without complications. On the third post-operative day, the East Hospital\u2019s physiotherapist and speech therapist, Em\u012blija Dravante<\/strong>, started working with the patient for him to be able to regain functionality. Currently, eight weeks after the surgery, the patient feels excellent and has commenced the next treatment phase, which involves post-operative radiation and chemotherapy.<\/p>\n

Photo: <\/em><\/strong>https:\/\/www.flickr.com\/photos\/austrumu_slimnicas_foto\/albums\/72177720321536545\/<\/em><\/strong><\/a><\/p>\n

The high-complexity surgery was performed by the East Hospital\u2019s multi-disciplinary team:<\/em><\/strong><\/p>\n

Head of the Head and Neck Surgery Department of the Oncological Surgery Clinic , Ren\u0101rs Deksnis<\/strong><\/em><\/p>\n

Plastic surgeon Dr. med. J\u0101nis Zari\u0146\u0161<\/strong> <\/em><\/p>\n

Plastic surgery resident Lidija Viktorija Arti\u0161evska<\/strong><\/em><\/p>\n

Otolaryngology resident Di\u0101na Katovi\u010da<\/strong><\/em><\/p>\n

Student at the Faculty of Medicine at the Riga Stradi\u0146\u0161 University, Kristi\u0101ns Vi\u0161perts<\/strong><\/em><\/p>\n

Anaesthesiologist Aija Krasti\u0146a<\/strong><\/em><\/p>\n

Nurses anaesthetists Zane V\u0113ja, Nat\u0101lija Porhomenko<\/strong><\/em><\/p>\n

OR nurses Elita Birzniece<\/strong><\/em>, Zita Za\u013civska<\/em><\/strong>, Anita Sli\u0161\u0101ne<\/em><\/strong><\/p>\n

Nurse assistants Dace Markovska<\/strong><\/em>, Laura Biez\u0101ka<\/em><\/strong><\/p>\n

\"\"<\/a><\/p>\n

Last year, the Head and Neck Surgery Department of the Oncological Surgery Clinic at the East Hospital saw a significant increase in the number of major and complex ENT surgeries performed by a multi-disciplinary team, from 60\u00a0surgeries in 2022 to 98\u00a0surgeries in 2023. The majority, or 98%, of patients undergoing surgeries in the Head and Neck Surgery Department of the Oncological Surgery Clinic are oncology patients requiring very complex surgical assistance. Additionally, the number of outpatient ENT consultations increased significantly, with 1421\u00a0consultations provided to patients last year.<\/p>\n

\n

About the East Hospital\u00a0 <\/em><\/strong><\/p>\n

Riga East Clinical University Hospital is the largest and strategically significant multi-profile hospital in the country. The hospital consists of five inpatient facilities\u00a0\u2013 Gai\u013cezers, Latvian Oncology Centre, Bi\u0137ernieki, Tuberculosis and Lung Disease Centre, and Latvian Infectious Diseases Centre, along with various specialised centres and clinics. The hospital provides highly specialised inpatient and secondary outpatient healthcare, offering multidisciplinary tertiary-level treatment and care in line with modern technology and medical knowledge. Approximately 80% of all cancer patients in Latvia are treated at the hospital. It serves as a practical training base for both Latvian educational institutions and foreign students, providing further education and knowledge transfer to healthcare specialists within and beyond the country. The hospital engages in scientific research and develops innovative methods for patient treatment. As the third-largest employer in the country, the hospital employs around 5000\u00a0staff members.<\/p>\n","protected":false},"excerpt":{"rendered":"

A multi-disciplinary team at the Riga East Clinical University Hospital (East Hospital) performed a challenging radical surgery on a 43-year-old patient to remove a head and neck tumor, which was the last viable option to halt the spread of malignant cells. Subsequently, the oncology patient became the first one in Latvia to undergo the transplantation<\/p>\n","protected":false},"author":49,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"class_list":["post-66350","page","type-page","status-publish","hentry"],"acf":[],"yoast_head":"\nEast Hospital performs a challenging radical surgical removal of head and neck tumor with successive complex reconstructive surgery - aSlimn\u012bca<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/aslimnica.lv\/en\/east-hospital-performs-a-challenging-radical-surgical-removal-of-head-and-neck-tumor-with-successive-complex-reconstructive-surgery\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"East Hospital performs a challenging radical surgical removal of head and neck tumor with successive complex reconstructive surgery - aSlimn\u012bca\" \/>\n<meta property=\"og:description\" content=\"A multi-disciplinary team at the Riga East Clinical University Hospital (East Hospital) performed a challenging radical surgery on a 43-year-old patient to remove a head and neck tumor, which was the last viable option to halt the spread of malignant cells. 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