NEW DELHI: AIIMS Delhi has come up with a technique that allows patients diagnosed with cancer in the lower part of the body and undergoing tumour removal to have a better life expectancy and good quality of life. In the nerve-sparing retroperitoneal lymph node dissection (NS-RPLND), which the institute has been following for the past two years, all lymph nodes are removed while the nerves remain undamaged. The cancer department at AIIMS has found that the patients diagnosed with various gynaecological cancers had more longevity with no bladder, bowel and sexual dysfunction after following this surgery technique. “To save the structure of internal body parts, the nerves are left untouched. Earlier, the surgeries would damage the nerves while removing the tumours, affecting the quality of life. A patient was suffering from around 60% damages, leading to bowel dysfunction, loose motion, erectile and ejaculation problems in men, and pain while having sexual intercourse in women,” said Dr M D Ray, professor at the surgical oncology department at AIIMS. The institute has performed 225 NS-RPLNDs, especially in cases of advanced ovary and endometrium cancers. Out of the 225 patients, 171 had ovarian cancer, 31 uterine cancer, 14 ovarian germ cell tumours, five ovarian granulosa cell tumours, and four endometrial stromal sarcoma, and 124 of them had the surgery after receiving neoadjuvant chemotherapy. “We experienced more technical challenges in post-chemotherapy surgeries. The technique offers modest bladder and bowel dysfunctions without an apparent higher risk of disease relapse. Post-chemotherapy surgeries may lead to significant blood loss and require vascular repair or reconstruction, which remains a challenge,” said Dr Ray. Earlier this week, his technique was accepted by Annual Cancer Congress of American College of Surgeons. However, it is a long operative time-taking procedure and a patient suffers from more blood loss compared with other conventional procedures. Dr Ray said, “It requires good understanding of anatomy and safe handling of retroperitoneal neurovascular structures such as adrenal glands, kidneys, ureters and abdominal aorta to prevent blood loss.” Calling it a feasible procedure without the need for any extra modern surgical equipment, he said it could be adopted in low/middle-income countries such as India.
Source: https://timesofindia.indiatimes.com/city/delhi/aiims-delhi-technique-offers-better-life-to-cancer-patients/articleshow/94977207.cms