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Multimodality treatment of mesothelioma with cytoreductive surgery and HIPEC (639689) | Rambam Health Care Campus Haifa - BookingHealth
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After that, you will undergo the necessary additional examination, such as the assessment of liver and kidney function, ultrasound scan and tomography of the abdominal organs. Based on the results of the examination, the physician will choose the surgical technique and the type of anesthesia. After that, preparation according to the preoperative standard will start.<\/p>\n\n<p style=\"text-align:justify\"><strong>Cytoreductive surgery<\/strong> begins with general anesthesia. The intervention is performed as open surgery, i.e. through the incision in the anterior abdominal wall, so that the surgeon can carefully examine the peritoneum and the surface of the abdominal organs. The surgeon removes affected by the malignant process areas of the peritoneum and metastases in other internal organs. This stage of the operation can take several hours, since the overall effectiveness of the treatment depends on the completeness of the malignant tissues removal.<\/p>\n\n<p style=\"text-align:justify\">At the next stage of the operation, the surgeon inserts several catheters into the abdominal cavity. Through the catheters, a heated solution of a chemotherapy drug is pumped inside. The special system maintains the required temperature (42-43 degrees Celsius), pressure and circulation rate of the medicinal solution. The solution mechanically flushes out blood clots and remnants of malignant tissues, and a heated chemotherapy drug destroys micrometastases in internal organs and lymph nodes (micrometastases can&rsquo;t be detected by the naked eye).<\/p>\n\n<p style=\"text-align:justify\">After 1-1.5 hours, the chemotherapy drug is removed from the abdominal cavity and the abdominal cavity is washed with saline. After that, the surgeon removes the catheters and sutures the incision of the anterior abdominal wall.<\/p>\n\n<p style=\"text-align:justify\"><strong>After the completion of the operation<\/strong>, you will be transferred to the ward of the intensive care unit, under the round-the-clock supervision of doctors and nurses. In 1-3 days after the operation, your drains will be removed and you will be transferred to a regular ward for further recovery. The whole treatment takes 10-12 days on average.<\/p>\n\n<p style=\"text-align:justify\">Finally, the attending physician will evaluate the results of <strong>control examinations<\/strong>, schedule the date of discharge from the hospital and give you detailed recommendations for further follow-up and treatment.<\/p>\n<\/div><div class=\"program_required_documents mt-4\"><h4>Required documents<\/h4><ul>\n\t<li style=\"text-align: justify;\">Medical records<\/li>\n\t<li style=\"text-align: justify;\">X-ray examination, MRI\/CT scan (if available)<\/li>\n\t<li style=\"text-align: justify;\">Pleural biopsy (if available)<\/li>\n<\/ul>\n<\/div>","program_full_story_crm":"<ul>\n\t<li>Initial presentation in the clinic<\/li>\n\t<li>clinical history taking<\/li>\n\t<li>review of medical records<\/li>\n\t<li>physical examination<\/li>\n\t<li>laboratory tests:\n\t<ul>\n\t\t<li>complete blood count<\/li>\n\t\t<li>general urine analysis<\/li>\n\t\t<li>biochemical analysis of blood<\/li>\n\t\t<li>TSH-basal, fT3, fT4<\/li>\n\t\t<li>tumor markers&nbsp;<\/li>\n\t\t<li>inflammation indicators (CRP, ESR)<\/li>\n\t\t<li>indicators of blood coagulation<\/li>\n\t<\/ul>\n\t<\/li>\n\t<li>abdominal ultrasound scan<\/li>\n\t<li>CT scan\/MRI or PET-CT of abdomen<\/li>\n\t<li>preoperative care<\/li>\n\t<li>cytoreductive surgery to remove visible tumors<br \/>\n\tinside the abdomen and HIPEC<\/li>\n\t<li>histological and immunohistochemical<br \/>\n\texamination of removed tissues<\/li>\n\t<li>symptomatic treatment<\/li>\n\t<li>cost of essential medicines<\/li>\n\t<li>nursing services<\/li>\n\t<li>stay in the hospital with a full board<\/li>\n\t<li>accommodation in a 2-bedroom ward<\/li>\n\t<li>elaboration of further recommendations<\/li>\n<\/ul>\n<div class=\"program_how_program_going mt-4\"><h4>How program is carried out<\/h4><p style=\"text-align:justify\"><strong>During the first visit<\/strong>, the physician will conduct a clinical examination and go through the results of the available diagnostic tests. After that, you will undergo the necessary additional examination, such as the assessment of liver and kidney function, ultrasound scan and tomography of the abdominal organs. Based on the results of the examination, the physician will choose the surgical technique and the type of anesthesia. After that, preparation according to the preoperative standard will start.<\/p>\n\n<p style=\"text-align:justify\"><strong>Cytoreductive surgery<\/strong> begins with general anesthesia. The intervention is performed as open surgery, i.e. through the incision in the anterior abdominal wall, so that the surgeon can carefully examine the peritoneum and the surface of the abdominal organs. The surgeon removes affected by the malignant process areas of the peritoneum and metastases in other internal organs. This stage of the operation can take several hours, since the overall effectiveness of the treatment depends on the completeness of the malignant tissues removal.<\/p>\n\n<p style=\"text-align:justify\">At the next stage of the operation, the surgeon inserts several catheters into the abdominal cavity. Through the catheters, a heated solution of a chemotherapy drug is pumped inside. The special system maintains the required temperature (42-43 degrees Celsius), pressure and circulation rate of the medicinal solution. The solution mechanically flushes out blood clots and remnants of malignant tissues, and a heated chemotherapy drug destroys micrometastases in internal organs and lymph nodes (micrometastases can&rsquo;t be detected by the naked eye).<\/p>\n\n<p style=\"text-align:justify\">After 1-1.5 hours, the chemotherapy drug is removed from the abdominal cavity and the abdominal cavity is washed with saline. 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Multimodality treatment of mesothelioma with cytoreductive surgery and HIPEC

Rambam Health Care Campus Haifa

Haifa, Israel
Program id # 639689
Doctor photo
Dr. med. Ran Kremer
Department of Thoracic Surgery
Specialized in: thoracic surgery

The program includes:

  • Initial presentation in the clinic
  • clinical history taking
  • review of medical records
  • physical examination
  • laboratory tests:
    • complete blood count
    • general urine analysis
    • biochemical analysis of blood
    • TSH-basal, fT3, fT4
    • tumor markers 
    • inflammation indicators (CRP, ESR)
    • indicators of blood coagulation
  • abdominal ultrasound scan
  • CT scan/MRI or PET-CT of abdomen
  • preoperative care
  • cytoreductive surgery to remove visible tumors
    inside the abdomen and HIPEC
  • histological and immunohistochemical
    examination of removed tissues
  • symptomatic treatment
  • cost of essential medicines
  • nursing services
  • stay in the hospital with a full board
  • accommodation in a 2-bedroom ward
  • elaboration of further recommendations

How program is carried out

During the first visit, the physician will conduct a clinical examination and go through the results of the available diagnostic tests. After that, you will undergo the necessary additional examination, such as the assessment of liver and kidney function, ultrasound scan and tomography of the abdominal organs. Based on the results of the examination, the physician will choose the surgical technique and the type of anesthesia. After that, preparation according to the preoperative standard will start.

Cytoreductive surgery begins with general anesthesia. The intervention is performed as open surgery, i.e. through the incision in the anterior abdominal wall, so that the surgeon can carefully examine the peritoneum and the surface of the abdominal organs. The surgeon removes affected by the malignant process areas of the peritoneum and metastases in other internal organs. This stage of the operation can take several hours, since the overall effectiveness of the treatment depends on the completeness of the malignant tissues removal.

At the next stage of the operation, the surgeon inserts several catheters into the abdominal cavity. Through the catheters, a heated solution of a chemotherapy drug is pumped inside. The special system maintains the required temperature (42-43 degrees Celsius), pressure and circulation rate of the medicinal solution. The solution mechanically flushes out blood clots and remnants of malignant tissues, and a heated chemotherapy drug destroys micrometastases in internal organs and lymph nodes (micrometastases can’t be detected by the naked eye).

After 1-1.5 hours, the chemotherapy drug is removed from the abdominal cavity and the abdominal cavity is washed with saline. After that, the surgeon removes the catheters and sutures the incision of the anterior abdominal wall.

After the completion of the operation, you will be transferred to the ward of the intensive care unit, under the round-the-clock supervision of doctors and nurses. In 1-3 days after the operation, your drains will be removed and you will be transferred to a regular ward for further recovery. The whole treatment takes 10-12 days on average.

Finally, the attending physician will evaluate the results of control examinations, schedule the date of discharge from the hospital and give you detailed recommendations for further follow-up and treatment.

Required documents

  • Medical records
  • X-ray examination, MRI/CT scan (if available)
  • Pleural biopsy (if available)

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About the department

The Department of Thoracic Surgery at the Rambam Health Care Campus Haifa offers all the options of modern medicine for the diagnostics and surgical treatment of thoracic diseases. The department's specialists mostly have to deal with operations on the esophagus, lungs, interventions to remove thoracic tumors, as well as with the treatment of injuries to the lungs and mediastinal organs. The surgeons have a perfect command of the modern surgical techniques, so they successfully perform even extremely complex interventions. The department is the largest and leading medical facility of this kind nationwide. The Chief Physician of the department is Dr. med. Ran Kremer.

The department annually performs about 500 operations, both open and minimally invasive. The department specializes in minimally invasive surgery on the thoracic organs. Most of these operations are performed using the very latest technology – video-assisted thoracoscopy, which eliminates the need for a classic open access.

In addition, the department carries out about 300 invasive x-ray- and CT-guided diagnostic procedures every year. The diagnostic spectrum also covers bronchoscopy, esophagoscopy, thoracoscopy, mediastinoscopy, fine-needle aspiration puncture biopsy and other tests.

The department's medical staff is constantly striving for excellence in the field of patient care, which is manifested in the high professionalism and emotional support of the patient and his family during hospitalization and follow-up monitoring. All employees of the department work fruitfully for the benefit of patients and are proud of their awards for excellent medical care from the management of the hospital, the Ministry of Health and the President of Israel.

The department's range of medical services includes:

  • Diagnostics and treatment of spontaneous pneumothorax
  • Diagnostics and treatment of dysphagia
    • Surgical interventions to eliminate the causes of swallowing disorders
    • Radiation therapy for detected neoplasms
    • Endoscopic treatments
    • Implantation of self-expanding stents for the restoration of esophageal patency
  • Diagnostics and treatment of small cell and non-small cell lung cancer
    • Pneumonectomy (total removal of the lung)
    • Lobectomy (removal of the lobe of the lung)
    • Segmentectomy (removal of a portion of the lobe of the lung)
    • Video-assisted thoracoscopic surgery
    • Stereotactic surgery (CyberKnife system)
    • Palliative care
  • Diagnostics and treatment of other diseases, other surgical techniques

Curriculum vitae

Dr. Ran Kremer is the Chief Physician of the Department of Thoracic Surgery at the Rambam Health Care Campus Haifa.

Dr. Kremer graduated with honors from the Rappaport Faculty of Medicine of the Technion (Israel Institute of Technology). He completed his training in General Thoracic Surgery at Rambam, and was a Fellow of the Lung Transplant Program at the Toronto General Hospital, Toronto, Canada. He introduced advanced Video-Assisted Thoracic Surgery (VATS) in Israel, which made him one of the leading surgeons in the country.

Dr. Kremer is a Clinical Lecturer at the Rappaport Faculty of Medicine and received the Best Lecturer of the Year Award. He also serves as the Chairman of the Morbidity and Mortality Committee at the Rambam’s Department of Surgery.

Dr. Kremer is a Member of the Israel Society of General Thoracic Surgery and a Board Member of the Scientific Council of the Israeli Society of Cardiothoracic Surgery.

His special interests include esophageal surgery and thoracic oncology. He is also involved in the active management of thoracic trauma patients.

Photo of the doctor: (c) Rambam Health Care Campus Haifa


About hospital

The Rambam Health Care Campus Haifa is the largest and the most progressive hospital in Northern Israel. The medical center was founded in 1938 and nowadays is proud of its long history, rich and successful experience in providing comprehensive medical services in all medical fields. The hospital serves more than 2 million locals, as well as the members of the Israel Defense Forces, UN Peacekeeping Forces and the United States Sixth Fleet. The medical center houses 61 inpatient departments, 73 specialized departments, 10 medical institutes and 25 laboratories. It is also the clinical and academic base of the Technion – Israel Institute of Technology.

The medical center includes the Ruth Rappaport Children's Hospital. It is a multidisciplinary medical facility specializing in the diagnostics and treatment of various pathologies, including extremely rare ones, in children of all age groups.

The total number of employees in the medical facility is 4,000 (715 doctors and 1,407 nurses). Many doctors are world-famous in the field of their clinical specialty and participate in advanced research projects in order to offer new treatment methods not only to their patients, but also to the world community.

The medical center is a leader in the field of medical care in emergency cases with a large number of victims. In addition, the hospital is certified in accordance with the strict standards of the Joint Commission International (JCI).

During the long-term and successful clinical practice, the medical center has formed a clear vision of optimal medical support and system of values. These suggest that the primary focus is always on the patient with his individual needs and wishes, while the medical services are professional, high-quality and safe. In addition, the specialists of the hospital apply the most effective and innovative treatment methods, as well as create a favorable environment, which contributes to the improvement of physical and emotional health and well-being of the patient. The key role in the daily work of the hospital is also played by a tolerant attitude towards all patients.

Photo: (c) depositphotos

Accommodation in hospital

Patients rooms

The patients of the Rambam Health Care Campus Haifa live in comfortable rooms designed in light colors. The standard room includes an automatically adjustable bed, a bedside table, a wardrobe for storing clothes, an armchair and chairs for receiving visitors, a TV, a telephone. Each room is equipped with an ensuite bathroom with shower and toilet.

Meals and Menus

The patients of the hospital are offered tasty and balanced three meals a day: breakfast, lunch and dinner. The menu also includes dietary and vegetarian dishes.

Further details

Standard rooms include:

Shower
Toilet
Wi-Fi
TV