Privatly-published Information Courrier
	I n f o C o u r r i e r
	2006 - №1	N. Shmatkov, MD, PhD

• Lymphostasis of lower extremities, hypernephroma of the third additional kidney with complications.
   Patient B.G.I., born 1949, in January 1984 complained to a gynecologist about the appearance of a tumor in the pelvic region of the abdomen. Patient received surgical treatment at the age of 33 – laparotomy. During the surgery it was discovered that tumor has enveloped the uterus, bladder and fat deposits of the abdomen. According to the USSR-time medical directives “About the involvement of other medical specialists in the case of the spread of cancerous tumor to multiple organs and systems” the emergency van was sent for urologist. In one hour the head doctor of the local urology department was found, and she was asked to remove the tumor from the bladder, and only after that gynecologists would finish their part of the surgery. During the surgery to remove tumor from the bladder, bladder was perforated and then both specialists declared cancer as inoperable, and installed a catheter into the bladder (epicystotomy). The abdominal wall was sutured. After 10 days the patient was discharged with an explanation that she has to live with the catheter for a long time. After that patient consulted multiple times with other specialists (gynecologists and urologists) who confirmed the advanced stage of the illness and recommended symptomatic treatment.
   In eight months after treatment at home patient presented with cahexia, edema of legs, ascites and enlargement of the tumor to the whole surface of the abdomen (over 40 cm in diameter).
   According to the treatment protocol of advanced cancer (Order issued on 10.02.1978.) patient was hospitalized to the Center of Lymphosurgery. In October 1984 she received following surgery: 1) removal of the abdominal tumor; 2) partial bladder resection, epicystotomy; 3) extirpation of uterus with additions; 4) resection of fat abdominal tissue; 5) lymphadenectomy under abdomen; 6) catheterization of three lymph vessels on the left and then on the right thigh. Diagnosis: cancer of the third additional kidney (hypernephroma) was verified.
   Patient received post-op cycle of endolymphatic drug therapy (ELDT) performed according to the protocol developed in our Medical Center. After 16 days the patient was discharged home. She received two additional cycles of ELDT treatment with two week interval for prophylactic reasons. Edema (lymphostasis) of the lower extremities disappeared.Today (14.12.2006) 22 years have passed. Patient is healthy and works at one of the enterprises in the town of Khartsyzsk as security guard. She periodically attends Center of Lymphosurgery.
   The question is “What is better – wide or narrow specialization?”
   The philosophy in our Medical Center is to provide active surgical help and access to modern medical technologies to all our patients, and especially to the patients with similar etiology of illnesses.

Before illness
After treatment at the Center of Lymphosurgery (happy grandmother 12 years post-op)

See next issue №8.