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The tumor was removed using a special ALPPS technique, which is performed in two procedures, and the operated baby is the youngest patient in the world who underwent such a procedure.
The operation was performed by a team of doctors led by prof. Aleksandar Sretenović from Tiršova and Dr. Srdjan Nikolić from the Institute of Oncology.
Nikolic says pediatricians discovered the baby’s tumor when he was three months old.
The tumor in the liver was 11 centimeters in size and the baby received chemotherapy for the first time at the Tirsova Children’s Clinic.
– After chemotherapy, the tumor shrunk to six centimeters. So we are prof. Sretenović and I decided to have surgery, to try to remove the tumor and preserve as much healthy liver as possible so that the boy could live, says Nikolić.
He points out that more than 30 percent of a healthy liver must be conserved so that that healthy part can regenerate and the patient can live. The necessary recordings were made and the doctors decided that it was only possible to test the ALPPS method, which is performed in adults and very rarely in children.
– The operation went well, as well as the postoperative period. When we reviewed the literature, we saw that this baby is the smallest child in the world who underwent this type of surgery, Nikolić said.
Explain that the ALPPS method of removing tumors in the liver is done in two procedures. In the first procedure, the disease is separated from the healthy part of the liver, the main blood vessel that carries blood to the liver is tied off, but only the branch that carries blood to the diseased part of the liver, while providing a supply normal blood to the healthy part of the organ.
– A small flow of blood is left in that diseased part of the liver so that it can perform any function. The healthy part of the liver regenerates in such a short time that it can take over full function, Nikolić explained.
Photo: I. Marinković
In seven to 10 days, the healthy part of the liver can double and only after it regenerates can the diseased part of the organ be removed.
Dr. Nikolic says that a multidisciplinary team is needed for this type of operation. That the oncologists of the Institute of Oncology and the surgeons of Tirsova have had a good cooperation during the last two or three years and that together they participate in the treatment of children with liver tumors.
Liver tumors are rare in children and Dr. Nikolic says they are very deadly if children are not operated on.
The ALPPS method is used in adults and this is the first time it has been used in Serbia for children, and a five-month-old baby is the youngest patient in the world to be operated with this method.
The literature describes that the youngest child who has been operated on by this method to date was 20 months old and the operation was performed in 2014.
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