A team of Rwandan medics at the University Teaching Hospital of Kigali (CHUK) on Wednesday, June 4 successfully conducted a complex six-hour liver surgery on a 10-month-old baby battling congenital liver cancer, a rare and life-threatening condition.
The procedure, known as a partial hepatectomy, involved removing over 70 percent of the baby’s liver, which had been ravaged by hepatoblastoma, a form of cancer that develops in children. The surgery was made even more challenging due to the child’s young age and low weight (only six kilograms) at the time of the operation.
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The baby, born in 2024, began experiencing complications just weeks after birth. He was referred to CHUK when he was only two and a half months old after doctors detected an abdominal mass, which was later diagnosed as liver cancer.
Initially, the tumour was deemed inoperable due to its size and location. The medical team opted for chemotherapy to shrink it. After six rounds of chemotherapy, the tumour persisted, prompting the doctors to reconsider surgery despite the high risks involved.
"The tumour was large and had engulfed more than half of the liver. Surgery was going to be very challenging,” said Dr. Alain Jules Ndibanje, the paediatric surgeon who led the team. "But based on liver anatomy and the unaffected vessels, we determined that it was possible.”
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One key factor that contributed to the surgery’s success was early diagnosis and referral. A small portion of the liver remained untouched by the tumour, making the procedure feasible. Still, the medical team faced hurdles, including securing specialised medication not readily available at the hospital.
Intensive planning preceded the surgery. Anaesthesiologists, nurses, and support staff worked together for weeks, ensuring everything was in place.
"It was not an easy preparation,” Dr. Ndibanje said. "For instance, the anaesthesia team had to spend about three hours preparing before the actual surgery.”
Dr. Françoise Nizeyimana, a paediatric anaesthesiologist on the team, recalled when she first heard about the case. "The surgeon told me, ‘I have a gift for you.’ When he explained it was a case of hepatoblastoma requiring partial hepatectomy, I said, ‘Wow, that’s a real gift.’ We began preparing immediately.”
She stressed the critical importance of assessing the patient’s fitness for surgery, especially since the baby had undergone chemotherapy. After extensive evaluation, her team determined that the child could handle the procedure.
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The surgery brought together a multidisciplinary team of about 20 people, including surgeons, anaesthesiologists, nurses, and support staff. Their mission: to remove the tumour and preserve enough healthy liver tissue to ensure the baby’s survival.
"According to what we observed after the operation, the baby responded very well,” Dr. Ndibanje reported. "In such procedures, even if a large part of the liver is removed, the remaining portion can still regenerate and function.”
When The New Times visited CHUK on Wednesday, June 4, the medical team was preparing to discharge the baby, who had made a promising recovery.
This successful operation not only marks a milestone for paediatric surgery in Rwanda but also showcases the growing capabilities of local healthcare professionals in tackling highly specialised procedures.