February 12, 2006

Sharon in Critical, Stable Condition After Surgery

JERUSALEM: Ariel Sharon was in a critical but stable condition yesterday after surgeons removed a decayed section of the comatose prime minister's large intestine, the hospital treating him said yesterday.

The four-hour operation on Saturday was successful, but Sharon's chances of recovering from a massive January 4 stroke have dimmed, doctors said.

Israelis closely followed their 77-year-old leader's latest ordeal, with TV stations repeatedly breaking into regular programming for updates, but the country already has come to terms with his departure from politics.

Sharon's political heir, Ehud Olmert, quickly took the reins as acting prime minister after Sharon's stroke, and appears poised to lead Sharon's centrist Kadima Party to victory in March 28 elections.

Sharon was rushed to surgery on Saturday morning after doctors, who had noticed abdominal swelling, conducted a CT scan and a laparoscopy, or insertion of a small camera through the abdominal wall.

Surgeons detected necrotic or dead tissue in the bowels and removed 50 centimetres, or one-third, of the large intestine, said Hadassah Hospital Director Shlomo Mor-Yosef. It was his seventh operation since suffering the stroke.

The necrosis was either caused by infection or a drop in the blood supply to the intestines, something common in comatose patients, the hospital director said. Mor-Yosef said doctors did not find blocked blood vessels.

Mor-Yosef said Saturday's surgery was relatively simple, and that Sharon's main medical problem continues to be the coma. Asked whether Sharon could come out of the coma, Mor-Yosef said: "All possibilities remain open, but with each passing day, the chances are lower."

The hospital statement yesterday morning said, "Prime Minister Ariel Sharon's condition stabilized after surgery, but it is still described this morning as critical and stable. The prime minister is in the general intensive care unit."

Since the stroke, Sharon has been hooked up a breathing tube. A feeding tube was inserted in his stomach on February 1.

Doctor R. Sean Morrison, a professor of geriatrics at the Mount Sinai School of Medicine in New York City, said that "long-term comatose patients typically die of complications like this," referring to necrosis.

Morrison said Sharon's prognosis was extremely grave even before the latest complication, and that chances for survival are now "extremely small, almost zero."

After being admitted to Hadassah on January 4, Sharon underwent three back-to-back brain surgeries. These were followed by three smaller procedures, including insertions of feeding and breathing tubes a sign that doctors were preparing for a long-term coma. Throughout the past five weeks, he had been in critical but stable condition.

Before dawn on Saturday, Sharon's condition deteriorated sharply and his life was in danger, hospital officials said. After consultation with his sons, Omri and Gilad, doctors decided to operate, said Mor-Yosef.

"During the operation, we found necrosis in part of his large intestine and ... the decision was to remove part of his large intestine," said the hospital director.

Sharon's sons have acquired guardianship over the prime minister since his incapacitation. Under Israeli law, any decision to perform emergency surgery or to discontinue medical treatment would require their consent, said Jonathan Davies, a leading Israeli medical law expert.