1.8kg tumor removed from infant after 9-hr operation

Panaji: In a nine hour surgery a team of doctors at Healthway Hospital, Panaji operated on a seven-month-old girl child and removed a liver tumor weighing 1.8kg.
The infant recovered well and was discharged from the hospital without complications, the hospital said.
The “mesenchymal hamartoma” tumor had grown from the central part of the infant’s liver and occupied most of her abdominal cavity, pushing aside her intestines and other organs.
“The challenges of removing large central liver tumors from small infants include meticulous dissection to reduce blood loss, preservation of blood supply to residual normal liver tissue on both sides of the tumor to prevent liver dysfunction after surgery,” said Dr Rahul Kakodkar, liver transplant surgeon.
Another challenge, Kakodkar said, was the anomalous blood supply of the liver in the infant arising from the superior mesenteric artery, something encountered in less than 5% persons.
Apart from the surgical challenges, anaesthetising for such major and prolonged surgery is understood to be very challenging and risky. There was risk of sudden life-threatening blood loss.
“Beat to beat monitoring with invasive lines in the major vein and artery, promptly replacing the blood and fluid loss, maintaining the vital parameters, body temperature and also providing adequate pain relief was very important. It was successfully managed by Dr Bharati Sawant, Dr Sandeep Pawar, Dr Sumant Prabhudessai and their team,” Kakodkar said.
Others who assisted the surgery were Dr Vishal Sawant, a neonatal surgeon and Dr Jean Louis Menezes, oncosurgeon as well as the medical team of nurses and technicians.
Sawant said that at times the liver tumors may be very extensive where the whole liver needs to be removed and liver transplant is the only hope in such children.