Gastric Cancer Surgery

Introduction

Gastric surgeries are usually performed in cases of gastric or stomach cancer. Gastric surgeries are extensive procedures. Part of stomach is removed depending on the site and stage of the disease.

Procedure and considerations

Before surgery bowel is cleared using laxatives. Patient usually is asked to fast overnight with not even water consumption. The surgery is performed under general anesthesia that renders the patient unconscious. After cleaning the skin over the abdomen with antiseptic lotions it is draped with sterile surgical drapes. The incision is made across the abdomen in the upper part. Sometimes if the oesophagus is involved, the incision may be extended to the lower part of the chest as well.

If the lower part of stomach is affected, only the lower part is removed. This procedure is known as partial gastrectomy. After the surgery the stomach will be smaller in size. If the middle part is affected then the whole of stomach is removed. After the operation the food tube is joined to the small gut. This procedure is called total gastrectomy with Roux-en-Y reconstruction.

If upper part of stomach is affected, an extended total gastrectomy may be done. The whole of stomach along with part of pancreas, omentum and the whole spleen is removed. The nearby lymph nodes may also be removed. Laparoscopic surgeries may be performed in these cases. The laparoscopic surgeries are always done by highly skilled and trained surgeons. If the junction of oesophagus or food pipe and stomach is affected, then part of the oesophagus is also removed. This is called oesophagogasstrectomy. The portion of food pipe will be then joined to small gut. During reconstruction part of the stomach may be given the shape of the food pipe.

textDuring surgery the adjoining lymph nodes will be carefully examined by the surgeon. If the lymph nodes are invaded by cancerous cells they will be dissected out. These lymph nodes are also sent to the pathologist for examination. They give clues to the spread of the cancer.

Risks associated with these procedures are of varying severity. Most common risks associated with these procedures are bleeding, infection etc.

Since these are extensive procedures, recovery usually takes longer time. Hospital stay after surgery is usually longer. Patient is allowed to be mobilised gradually. After discharge from hospital the patient is advice to lead a restricted life initially. Dietary restriction and modifications should be followed very strictly. Regular follow ups are essential for restoration of normal life and early detection of recurrence.