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Doctors speak on Heather McNamara's case

Dr. Tomoaki Kato, surgical director of liver and intestinal transplantation at NewYork-Presbyterian Hospital/Columbia University Medical Center, and Dr. Steven Lobritto, pediatric medical director for liver and small bowel transplantation at the Morgan Stanley Children's Hospital of New York speak out on Heather McNamara's case.

Why was this surgery used on this patient?

"The only possible cure for this disease is complete surgical removal," Kato said. The abdominal inflammatory myofibroblastic tumor did not respond to chemotherapy and had been otherwise deemed inoperable.

How was the surgery done?

The 23-hour procedure began with about eight hours of "dissection," Kato said, during which surgeons examined up-close the tennis ball-sized tumor, which had overtaken the pancreas and was surrounding major blood vessels. Then, along with the tumor, the stomach, pancreas, liver, spleen, small intestine and large intestine were removed. Surgeons separated the liver, small intestine and large intestine from the tumor. The other three organs, determined too compromised by the tumor, were not put back into the girl's body. Blood vessels in the abdomen were replaced with tissue from other parts of the body or reformed with Gore-Tex fabric. The liver and intestines were put back into the body and reconnected to the other organs.

It was believed to be the first time this surgery was performed on a child.

What was the patient's recovery like?

"The recovery so far is great," said Kato, adding that the patient will have some ongoing medical issues. With the removal of her pancreas - the organ that regulates insulin levels - the girl became diabetic. She also lost her spleen, which protects against infections, and will need to take antibiotics for the next several years. Although she's not yet eating normally, the removal of her stomach is not likely to cause lasting problems, Lobritto said.

What is her long-term diagnosis?

The doctors believe they have completely removed the tumor. If the tumor does not recur and her medication staves off infections, Lobritto said, "she can live a very decent life."


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