The doctors of the capital removed the largest chest tumour weighing 13.85 kgs claiming it to be the world’s largest tumour and the medically challenging rare surgery.

Dr Udgeath Dhir, Director and Head, CTVS, Fortis Memorial Research Institute along with his team of doctors which included four doctors three anesthetist and four staffers successfully removed the world’s largest chest tumour weighing 13.85 kgs from the chest of a 25-year-old young male patient. As per the available medical literature and published papers, the largest chest tumour removed till date, prior to this case was in Gujarat in 2015 weighing 9.5 kgs.

Patient Devesh Sharma was presented in an extremely critical condition at Fortis Memorial Research Institute, Gurugram, with breathlessness and extreme uneasiness in the chest. He wasn’t able to sleep straight on the bed due to breathing trouble since past 2-3 months. Upon evaluation at another hospital in the city, the pulmonologist had advised him for a chest CT scan.

The scan report indicated a massive tumour in the chest which was occupying more than 90% of the chest area, engulfing the heart and displacing both lungs which led to only 10% of the lungs functioning.

In addition to the criticality of the surgery, the patient had a very rare blood group, AB negative. In cases, where patients have large tumours in the chest, the administration of anaesthesia becomes even critical.

To avoid any risk to the surgery, doctors had to prepare the patient under local anaesthesia. Speaking about the complex surgery, Dr Udgeath Dhir, Director and Head, CTVS, Fortis Hospital, Gurugram said, “The patient came to us in a very critical condition as his lungs were compressed owing to the size of the tumour in the chest due to which he was not able to carry his daily routine activities.”

He further said, “It was 4-hour surgery which involved opening of both the sides of the chest. The tumour owing to its vast size couldn’t be removed through minimal invasive surgery and thus it was required to be cut and further enable the removal of the gigantic tumour from the patient’s chest. Throughout the procedure, maintaining adequate blood flow was critical. A lot of precision is required in such surgical procedures as the patient can even collapse, if the procedure is not done with acute precision. This was a high risk surgery owing to the bulk of the tumour which had occupied the entire chest making it difficult to operate on multiple vessels.”

“Post the surgery, the patient was shifted to ICU after doing adequate hemostasis and was extubated the next day.  Initially he was kept on ventilation and later weaned off. However, the carbon dioxide in his blood started rising owing to which his lungs which had initially contracted started expanding leading to re-expansion Pulmonary Edema (RPE). We tried to manage this conservatively without invasive ventilator support, but after 48 hours had to put him back on ventilator,” informed the doctor.

“Considering his condition, we decided to do a tracheostomy, where we created a mini hole in the neck so that we could take out his secretions since he had also developed dense adhesions in his heart. The patient stayed in ICU for 39 days’ post which he was shifted to room and his tracheostomy was removed. The patient is doing well, and on bare minimal oxygen support,” added Dr Dhir.

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