Life for patients after metastasis – liver operation- prof. dr Aleksandar Karamarković
The time when patients who had carcinoma were “forgotten” are behind us. Nowadays thanks to complex operations – liver resections, have much more possibility to live longer and to have quality life. Professor of Medical Faculty, general surgeon dr Aleksandar Karamarković with his team regularly performs liver surgery. Professor says that results are extraordinary thanks to excellent equipment, but also thanks to surgical techniques.
WHAT IS LIVER RESECTION?
Liver resection is surgical removal of all, or a portion of the liver after certain pathological process, the most often malignant tumors that made metastasis in the liver. When part of the liver with metastasis is removed we free this organ from bad tissue and thus we enable the patients to get chance to extend life. The most often we can see metastasis in colorectal cancer where this method could be useful.
Is it good to treat patients with metastasis with cytostatics that hold its place in therapy for extension of life or to opt for surgery?
“Surgery is golden standard. Of course, all decisions are made in conciliar way and in multidisciplinary approach. However, it is fact that not all patients can be subjected to surgical intervention and all depends upon number and size of metastasis, their position in the liver-whether they are only in just one place or all over the liver.” – explains professor Karamarković.
HOW MUCH LIVER CAN BE RESECTED?
“Surgery can remove up to two thirds of the liver, it means 70 percent, and 30 percent of the remaining liver is enough so that body accept function of this organ” – says professor dr Karamarković. Here special expert’s attention should be paid to resection in “two acts” technique. According to dr Karamarković, in first act blood vessels of sick part of the liver are sealed, so that healthy part could be enlarged, and after that resection is made. Between these two acts it is necessary to make pause of four to six weeks.
WHICH LIVER OPERATIONS ARE PERFORMED IN THE ATLAS GENERAL HOSPITAL?
In Atlas General Hospital very complex operations in general surgery are performed within Center for liver surgery and Center for Digestive Surgery that consist of large number of experts.
Team that performs liver surgery is made of eminent surgeons: prof. sci med dr Srbislav Knežević, prof dr Aleksandar Karamarković, doc. dr Danijel Galun, doc. dr Đorđe Knežević, ass dr sci med Slavenko Ostojić, ass dr Borislav Tošković, mr dr sci med Predrag Bulajić…
In Atlas General Hospital are performed so called synchronous resections: in the same time metastasis are removed and operation of colon cancer is done.
Our experts have years of experience in surgical treatments of liver diseases in complicated operations of benign and malign liver diseases:
- Primary hepatic malignancy of liver and biliary tract – hepatocellular and cholangiocellular cancer, klatskin tumor.
- Secondary deposits, metastasis in the liver in colon carcinoma.
- Benign liver diseases, like echinococcus cysts, large liver hemangiomas, liver cysts etc.
Thanks to cooperation with Medtronic company, Atlas General Hospital is currently the only completely equipped private hospital for performing such complicated operations. Beside such great experience of the experts of Atlas General Hospitals we have extremely good equipment and thus it is possible that beside classical operations we can successfully apply new technologies:
TACE –transarterial chemoembolization of the liver in those patients where surgical treatment is not possible.
Evident Microwave – microwave system is exceptionally good for resections of malignant liver tumors.
WHY LIVER SURGERY IS SO COMPLICATED?
Huge problem of liver surgery is that this organ has dual blood supply which represent great risk for the patient. Resections are very complex operations because liver is loaded with blood. Today recovery of the patients is much shorter then before because now patient loses less blood (minimal amount) after liver surgery and risk of complications is much lower, says professor of Medical Faculty, surgeon that performs operations in Clinical Center of Serbia and Atlas General in Hospital, prof. dr Aleksandar Karamarković.
Profesor Karamarković wrote the book ” Resection liver surgery“. This book is accepted as class book on Faculty of Medicine. Prof Karamarković is lecturer on all professional symposiums in country and abroad.
HOW SURGERIES ARE PERFORMED WITH MINIMAL LOSS OF BLOOD?
In Atlas General Hospital we use autotransfusion system, co called Cell Saver. Blood of the patient during the operation itself is collected and filtered in a special system, and after that is returned as auto transfusion, so the operations are performed with minimal loss of blood.
“System is used so the blood of the patients that is lost during the operational treatment is collected in special containers, it is filtered, it is then packed in special systems, so that compensation is practically is done during the operation itself and is then given like ordinary transfusion”, says dr Vladan Milošević – anesthesiologist.
With using Cell Saver problems are practically nonexistent because during this method of auto transfusion blood is taken form the patient itself. Thus we are able to avoid transfusion in urgent situations. Infections and complications are reduced during use of blood.