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Surgical Oncology- Regional Chemotherapy - Unit |
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| Director | : Prof. Joseph M. Klausner |
Main description
Isolated Limb Perfusion (ILP) is indicated for patients with cancer confined to the limbs. The major blood vessels of the affected limb are cannulated and connected to an artificial heart-lung machine, thereby disconnecting the limb from the systemic circulation. This facilitates administration of very large quantities of chemotherapeutic drugs to the affected limb only, avoiding systemic toxicity. ILP nowadays includes the administration of Tumor Necrosis Factor (TNF) which has been shown to have a profound anti-cancer effect in experimental animals. Attempts to implement it clinically in cancer patients failed because of severe immediate life-threatening side effects, resulting in its being virtually abandoned for clinical use. Its implementation in the ILP system suits the needs of patients with metastatic melanoma and advanced soft tissue or bone sarcoma confined to the limb. The results are impressive with almost 90% response and limb salvage rates. Implementation of this novel technique has made our department a national referral center for advanced stage cancer patients.
Cytoreduction and heated intraoperative-intraperitoneal chemotherapy:
This is regional chemotherapy for abdominal carcinomatosis. Until recently, these patients were considered incurable with the only treatment option being systemic chemotherapy producing very low response rates. Most patients, therefore, went untreated until symptoms occurred in which case palliative measures were taken. Recent studies have shown that a selected subgroup of these patients is treatable despite their advanced disease. The treatment involves two components; the first being extensive surgical removal of all visible tumors. Typically, this includes resection of all involved organs, such as female genitalia, small and large intestines, stomach and stripping of the peritoneum itself. Sometimes, literally hundreds of tumors are removed in an attempt to achieve complete cytoreduction. At the end of the cytoreduction procedure, the abdominal cavity is flushed with high concentrations of chemotherapeutic drugs delivered with the aid of a heart-lung machine at a high temperature of 43oC. This is required to affect the microscopic tumors that are not visible to the surgeon.
medical staff
Dr. Subhi Abu-Abied, Specialist, General Surgery
Dr. Dina Lev-Chelouche, Specialist, General Surgery
appointments972-3-6973305 |
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