Record-breaking surgery in Pisa: a 'super-giant' tumor successfully removed.
A delicate operation performed inside an operating room (Archive photo)
Pisa, July 9, 2025 – A unique and innovative procedure to remove a specific type of tumor was performed in Pisa by the multidisciplinary team of the Organ-Sparing Liver Surgery Section of the AOUP (Italian National Hospital for Liver Surgery) directed by Lucio Urbani.
The patient was a seventy-year-old woman who had initially been started on chemotherapy for palliative purposes due to a hepatocellular carcinoma that, due to its size exceeding 15 cm, is defined in the scientific literature as "supergiant." Initially, any local treatment, whether interventional radiology or surgery, was ruled out due to the involvement of the major vascular axes of the liver.
The case, however, came to the attention of the Multidisciplinary-Multiprofessional Group of Organ-Sparing Liver Surgery at the University Hospital of Pisa for a second consultation . Over the years, the Group has distinguished itself by introducing cutting-edge surgical techniques and, by exploiting the constant technological progress of preoperative radiological imaging and intraoperative ultrasound, has planned extremely complex interventions, often performed for the first time in the world, thanks to the great therapeutic potential of this type of surgery.
In this specific case, the multidisciplinary team (comprising oncologists, radiologists, pathologists, hepatologists, anesthesiologists/resuscitators, surgeons, nurses, and highly skilled dedicated technicians) deemed radical surgical removal of the tumor feasible. The procedure lasted more than 15 hours, with the operating room staff severely strained from the initial stages, when the patient suffered an unexpected cardiac arrest.
Intraoperative cardiac arrest is a very serious complication that, even when resolved, usually prevents the surgery from continuing . During this phase, the anesthesiologists (Gabriella Licitra, Daniele Anacleto Meiattini, and Chiara Leoni) played a crucial role. Together with the resuscitators (led by Francesco Forfori), they restored hemodynamic stability and jointly assessed the possibility of completing the surgery. And so it was, the surgery was able to proceed, entering the most crucial phase: reconstruction of the hepatocaval confluence to ensure proper function of the residual liver. The patient was discharged from the hospital after two weeks in excellent general condition. Eight months after the surgery, she is free of disease, doing well, and enjoying the beach season.
La Nazione
