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Woman's Abdominal Organs Removed in Unique Cancer Surgery
Date:3/24/2008

Taking out stomach, pancreas, liver, spleen, small intestine and large intestine led to lifesaving operation

MONDAY, March 24 (HealthDay News) -- Brooke Zepp, a 63-year-old South Florida woman, was diagnosed last May with leiomyosarcoma, a rare cancerous tumor deep inside her abdomen that had wrapped itself around her aorta and other arteries that supply blood to vital organs such as the stomach, intestines and spleen.

Surgery wasn't an option, she was told, because there was literally no room to remove the tumor without damaging those vital organs. She was given six months to live.

Refusing to give up, Zepp went to the University of Miami/Jackson Memorial Medical Center, where surgeons at The Transplant Institute performed what's believed to be the first operation of its kind: Early this month, they removed six of her internal organs, freeing up space to cut out the cancer, and then they reinserted the organs.

Usually, this is an inoperable tumor, Dr. Andreas Tzakis, director of The Transplant Institute, said during a Monday teleconference. "In order to remove the tumor, we took a very unusual approach. We removed all the organs along with the blood vessels and the tumor," he said.

Before undergoing the operation, Zepp had tried chemotherapy and radiation, both of which failed. The only option left was surgery, "but no one wanted to operate," Zepp said during the teleconference.

"Because people wouldn't operate and I wanted to live, I said, 'Somebody has to do it first,' " Zepp said. "And I wanted to prove to people, even though many doctors told me not to do this, that I thought it would be better to take a chance on living than on dying."

The organs removed during the 15-hour surgery were the stomach, pancreas, liver, spleen, small intestine and about two-thirds of the large intestine. Because of their delicate nature, the kidneys weren't taken out during the procedure, Tzakis noted.

"We had to move very quickly because the organs were removed from her body and she had no organs in the belly. And we had to move quickly to cut the tumor out," Tzakis said.

Once the tumor had been removed, Zepp's organs -- which had been kept chilled -- were placed back in her abdominal cavity and artificial blood vessels were put in and connected. In total, the organs were outside her body for about 90 minutes, Tzakis said.

Tzakis said the idea for the surgery was a natural extension of the work his team had been doing with multiple organ transplants.

"This is unique and brand-new, but pieces of the surgery were done before," Tzakis said. "We know how to remove organs -- we know how to put them in. We've done surgery to remove liver tumors, taking the liver out of the body, removing the tumor and putting the liver back in."

The Miami doctors have also performed similar operations removing tumors from intestines, Tzakis said. "So this came to us kind of naturally. We've done pieces, we just hadn't done the entire thing at one time," he added.

Zepp said she feels good. "I feel like I'm coming through a tunnel and I have a whole life ahead of me," she said.

She added: "I want the rest of the world to know that inoperable cancers can be operated on. Different cancer centers have different training and their own vision, and they don't think in the terms that a transplant surgeon would."

More information

For more on leiomyosarcoma, visit the American Cancer Society.



SOURCES: March 24, 2008, teleconference with Andreas Tzakis, M.D., director, The Transplant Institute, University of Miami/Jackson Memorial Medical Center; Brooke Zepp, Pompano Beach, Fla.


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