Oncologists conducting modern miracles

Breakthrough in oncology, thoracic surgery and development of cell technologies at N.N. Alexandrov National Cancer Centre of Belarus
Our doctors are the first to create a prosthetic trachea accepted by a patient’s body; so far, no other global attempts have been successful. In many respects, there are no artificial materials which can replace the trachea wall but Belarusian oncologists have developed a high-tech solution, allowing Anatoly Khlopkov, 65, from Rogachev to breathe again.

Anatoly was admitted to the Borovlyany cancer centre on having difficulty breathing and swallowing, and it was thought that lung cancer had spread to the trachea. He agreed to the innovative surgery, guided by his belief in the doctors and his huge desire to live. After three months, it’s apparent that his body isn’t rejecting the artificial trachea: a true victory for him, and for the doctors.

Belarus is known for its transplantology expertise but there remains a shortage of organ donations and cancer patients often need a match without delay. The Director of the Centre, Oleg Sukonko, tells us, with pride, “We decided to follow the path of creating artificial organs, via tissue-engineering, to make a prosthetic trachea. The patient had the operation three months ago, and we can already say that the surgery was a success. Today is a happy day for us: a day we’ve been working towards for five years.”

Patient Anatoly Khlopkov (second row, on the right) with oncologists

There have been other attempts to create artificial trachea worldwide but none have been successful, failing to contract and allow patients to clear their throat, or cough up phlegm. Many died from pneumonia following the surgery. Thoracic surgeon Vladimir Zharkov, who heads the surgical department of the oncology centre, led the team behind the innovation, which requires five stages. First, a matrix is created from a donor trachea, and cleared of all cell elements, to become universal, to suit any tissue type. To allow it to grow, it is implanted into the patient’s rectus abdominis muscle: a stage crucial to success.  At the Centre of Children’s Oncology, Haematology and Immunology, doctors separated stem cells from marrow, increased their weight and transformed them into cartilaginous trachea cells. Then, by means of injection, they were ‘settled’ into the prosthesis. The main, final surgery followed, with the removal of damaged trachea and lung and relocation of tissue-engineering tracheas from the stomach area into the thorax.

Professor Vladimir Zharkov shows us computerised axial tomography images, saying, “Here are pictures before the surgery: in the top part of the lung, there was a large tumour which penetrated the trachea, narrowing the lumina to a critical 3-4mm (down from 3cm). The pictures afterwards show that everything is fine.”

Oncologists are sure that the new technology will not only save lives where, previously, there would have been no hope, but that it may be used to create other tissues needed by patients.

By Yulia Vasilieva

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