Professor Dr. Ranko Lazović, head of digestive surgery at the Clinical Center of Montenegro (KCCG), performed an operation that represents the largest surgical undertaking in the country, and which in the United States of America (USA) costs about half a million dollars.
Lazović operated on a patient with an advanced stage of ovarian cancer, who had already been operated on in Belgrade and received chemotherapy.
The procedure is possible for such patients, who have been told that nothing more can be done, but also for patients who have not previously been operated on but only received chemotherapy.
"When you subject someone who has three or six months to live to this kind of intervention, it sufficiently illustrates the complexity, justification and seriousness of the method," Lazović said today at a press conference.
This procedure was started in the USA at the beginning of this century by doctor Paul Sugarbaker, employed at the Cancer Center in Washington.
Lazović explained that this is the most complex surgical intervention in the abdomen and pelvis, which is usually performed on women aged 35 to 40.
The method, he claims, is reserved for ovarian cancer, where it gives the best results, as well as colon and appendix cancer.
"The five-year survival of such patients is over 20 percent, and there are studies that say that the five-year survival is more than 40 and 60 percent," said Lazović.
Lazović said that the ideal patients for this procedure are those whose cancer index, which shows the extent of the process in the abdomen and pelvis, should be up to 21.
In such a procedure, radiologists perform first, then surgeons and anesthesiologists.
"The operation has two stages, one is an open surgery where all the surfaces affected by the metastasis are removed, and this is called a cytoreductive procedure. When we finish this process, which lasts for hours, the abdomen must be completely dry and washed with a saline solution to completely remove the metastases. Then "Five drains are placed, one of which is the inlet, while four are used for cytostatic circulation. In two liters of physiological solution, the dose of cytostatic is dissolved depending on body weight, age, there is an exact formula," said Lazović.
He explained that the solution with cytostatics, at a temperature of 42 degrees, is introduced into the abdomen via a pump, which must always contain 500 milliliters of the solution.
"The solution circulates and flushes for 60 minutes. During this time, the anesthesiologist determines the level of leukocytes every 10 minutes and takes care of the amount of urine excreted and the parameters of kidney function. After 60 minutes, the patient is removed from the pump, the drains are attached to the bags and the patient moves to intensive care unit," explained Lazović.
Such patients, he said, are monitored for the next six days, and if everything goes well after that period, they can take food, walk and be stable.
Apart from Lazović, Serbian doctor Dragutin Kecmanović from the Clinical Center of Serbia works in these areas.
In order to apply this procedure, Lazović was first educated by Professor Kecmanović, to whom he is especially grateful, then in Germany, and a third time again in the team of Kecmanović and the father of this method, Sugarbaker, in Belgrade.
KC Director Jevto Eraković said that preparations for this method lasted a year.
"Doctor Ognjenka Šarenac did a great anesthesiology education and they did an impressive job," said Eraković.
The operated patient, Refija Muzurović from Bijelo Polje, told reporters today that she feels good, thanks to Professor Lazović.
"I'll be fine. I'm looking ahead, I'm optimistic and I have more reason to be optimistic. I never said I was going to die and that I was sick. I walk, eat, walk. I'm no longer a sick woman," Muzurović said.
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