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About the procedure that Melania Trump underwent – says urologist Dr. Jan Karol Wolski from the Warsaw Cancer Center. The First Lady had kidney tumor surgery on Monday at the Walter Reed National Military Medical Center near Washington, DC. She is to stay in the hospital until the end of the week. Her kidney embolization was performed, which is used in the treatment of benign and malignant neoplastic changes.
- A spokeswoman, Stephanie Grisham, announced that 48-year-old Ms. Trump has undergone an embolization procedure to treat kidney disease
- The procedure was successful and there were no complications
Embolization inhibits the blood supply
Urologist Dr. Jan Karol Wolski from the Warsaw Cancer Center explains that the embolization of a kidney tumor consists in clogging the blood vessels leading to a disease lesion in this organ. They can be malignant and benign tumors.
The doctor makes a puncture in the groin and inserts a catheter into the femoral artery. Thanks to the application of a special dye to the blood vessels, the so-called contrast, the operator operating on the monitor screen can see exactly all the vessels that are affected by the lesion. In order to reach the kidney by the femoral artery, it is necessary to travel some 40 cm to even half a meter. Then the vessel supplying the blood to the lesion becomes clogged, causing its necrosis. For this, we use plugs made of the patient’s blood clots, tissue adhesives, hemostatic sponges or tiny springs that stick to the vessel and clog it.
The procedure is performed by an interventional radiologist under local anesthesia. So the patient is conscious.
Management depends on the type and stage of neoplasm
– Embolization is most often done when the patient is bleeding heavily from the kidney that has cancerous change. Its performance enables the tumor to be removed later, which usually reduces blood loss during the procedure. It can also be performed as a method of palliative treatment in the case of an inoperable tumor causing haematuria or pain. However, if the lesion is small and benign, it is left for observation after embolization, explains the urologist.
To determine if a tumor is malignant, a fragment of it must be examined. It can be taken through the skin with a special needle before embolization or during embolization the pathologist must assess the type of lesion.
– According to media reports, the US First Lady did not treat kidney cysts, because they are usually punctured. Melania Trump may have had a mild change in AML, or angiomyoma, leiomyomata. These are quite common changes that occur in the kidneys. When they are small, we only watch them. Large ones require excision or embolization. Another likely benign lesion is mesoblastic cystic nephroblastoma. It is a remnant of fetal life, which, if it grows larger, may cause kidney bleeding – says Dr. Wolski.
Prevention of complications
The embolization procedure is a minimally invasive procedure. According to the specialist, the patient remained under observation in the hospital in order to prevent possible complications. It could be some kind of infection. Sometimes blockage of the blood supply to the tumor causes its rapid necrosis and rupture. Then there may be secondary bleeding and the so-called post-embolization syndrome. Symptoms may include fever, nausea, vomiting, and abdominal or lumbar pain appearing within 2-3 days after embolization. Treatment of the post-embolization syndrome is symptomatic and includes the use of hydration, analgesics and antipyretics.
Since Nancy Reagan had her mastectomy in 1987, none of the First Ladies had had such a major medical procedure. Earlier, Rosalynn Carter had surgery to remove a benign tumor from her breast in 1977 and Betty Ford had a mastectomy in September 1974.