Surgical treatment is aimed at resection of the malignancy and stomach segment, or completely the entire body. Volume determined by the type and stage of disease. Wide range of operations from the application to endoscopic resection extended surgical interventions.
This type of therapy is appointed at all stages of the disease. In general good health surgery is an effective treatment for 0, I, II, III or phases of the disease. At step IV is used if no secondary lesions in distant organs.
Surgery for stomach cancer may be of a palliative nature, facilitating or preventing the development of symptoms. For example, surgery aims to prevent entry or exit blocking tumor in the stomach bleeding warning of malignancy and so forth.
Selection of operation due to the location of tumors and the spread of the pathological process in the body. Surgical intervention lasts on average from two to three and a half hours.
The preparatory phase prior to surgery for gastric cancer
Surgery precedes diagnosis: CT or PET-CT, gastroscopy with biopsies, X-rays of the chest and laboratory tests, ECG, in some cases, endoscopic ultrasound, consultation anesthesiologist.
Seven days before resection stops taking the medication, contributing to liquefaction of blood, as well as vitamin E.
Endoscope approach the clinic Assuta
This type of surgery for gastric cancer is rare enough, most of the surgeries are cavitary. For tumor resection used endoscope. Indications for the procedure can only be early stage at which the risk of lymph node low.
The procedure is as follows. In order to mark the limits of mucosal resection special dyes used by electrocoagulation. With the endoscope is inserted electrotome, resecting pathologic mucosal site using a visual control.
This minimally invasive technique reduces the period of hospitalization and rehabilitation.
Surgery for stomach cancer: partial gastrectomy
In most cases, this type of surgery for gastric cancer is used when a malignancy is located in the lower body segment, and in rare cases - at the top. Resected portion of the stomach, esophagus sometimes capture areas and small intestine. Volume determined by the localization of the tumor. Distinguish partial resection of the distal (gastric deleted segment closely spaced from the gut), proximal (near the esophageal tumor removal). After surgery, body size reduced.
Surgery to remove the stomach - a total gastrectomy in the clinic Assuta
The indications for it is the location of tumors in the upper part of the organ near the esophagus, as well as the involvement of the whole body - the stomach in the pathological process.
In addition to the removal of the affected organ resection may affect spleen, pancreas gland segment or completely, lymph nodes, esophagus portion intestine, omentum.
Ezofagogastrektomii indication to the localization of tumors close to the esophagus. At the end of the upper part of the esophagus was ligated to the small intestine. In some cases it is possible to maintain the distal section of the stomach, which is connected to the esophagus segment.
After surgery to remove the stomach is possible to create a new body by the intestinal tissues. Learn more about gastrectomy surgery can be read here .
Surgery for stomach cancer: LND
Any operation gastrectomy involves removing lymph nodes and closely spaced portion omentum (a fatty layer that covers the stomach and intestines). The quantity or the volume removed lymph nodes is determined depending on the stage of the disease.
According to most doctors, the effectiveness of surgery for stomach cancer directly determines the number of lymph nodes. To carry out dissection and requires highly experienced surgeons.
Surgery for stomach cancer: laparoscopic gastrectomy
In clinic Assuta can successfully used laparoscopic or minimally invasive approach. The operation is performed through small incisions using a laparoscope and other instruments. For its implementation requires only a trained and experienced surgeon. This type gastrectomy accompanied by fewer complications.
However, in a few cases (3.1%) replaced by laparoscopic abdominal surgery. This may be caused by non-standard localization of malignancy or its size, complexity to the control of bleeding, inability to resect the required number of nodes.
Due to the fact that after an operation to remove the stomach in some patients have problems with taking the necessary amount of food. Moreover, irradiation with chemotherapy methods make the problem worse. Install gastrostomy - feeding tube in the stomach or create an outer jejunal fistula - enterostomy, through which through openings the food in liquid form can act directly into the intestines. This type of enteral or tube feeding.
Palliative surgery for gastric cancer in the clinic Assuta
The spectrum of palliative surgery is extensive: from partial resection up combined interventions.
The main thrust - to prevent complications (stenosis, bleeding). Moreover, resection of the primary malignancy in relieving symptoms of intoxication, it is easier to treat symptoms of the disease, due to the reduction of the tumor mass increases the effectiveness of chemo - and radiotherapy.
Sometimes the cancer interferes with the movement of food through the digestive system. Then, a slight amount of food mass causes a feeling of fullness. There are features such as nausea and vomiting, constipation, pain. In some cases, to eliminate these manifestations there is a need for resection of the stomach segment, or completely body. Choosing the type of operation will depend on the specific symptoms, the magnitude and location of the malignancy, as well as the general health of the patient.
In some cases, made gastrojejunostomy or bypass surgery. Then a segment of the stomach, where there is a blockage, combined with the initial section of the small intestine, bypassing the affected part of the body.
Also carried endoscopic ablation, during the execution of which by a laser beam and the endoscope destroy tumor. This stops the bleeding and reduces the size of tumors without surgery.
Patency preserve food by setting the stomach wall. If a malignant tumor is located in the upper body segment, the stent disposed between the esophagus and the stomach, lower - between the small intestine and the stomach.
After surgery for gastric cancer
For a while the patient is in the intensive care ward, then in the surgical department. Motor activity reduces the risk of complications (blood clots, etc.), But also speeds up the whole process of rehabilitation. Soft and liquid foods gradually change to a solid. Provides recommendations regarding diet: frequent and smaller meals in small portions.
Undesirable effects after surgery for gastric cancer
This type of surgery is complex implementation. Possible complications include the risk of blood clots, bleeding, damage to adjacent organs, "leaks" reconstituted organs and others.
There is a certain statistics: one - two percent mortality as a result of this operation. When lymph node dissection, this figure increases slightly. It is extremely important to carry out highly gastrectomy surgeon.
Adverse effects of the operation for gastric cancer include: pain in the abdomen, especially during a meal; frequent heartburn, rapid heartbeat, dizziness, lack of vitamins. Thanks to the stomach is carried out the process of absorption of vitamins from food. After gastrectomy physicians prescribe vitamin and mineral supplements - iron, calcium, vitamin B12, vitamin D, folic acid, part of which is administered only by injection. Also changed the diet, especially the amount of servings and eating regime.
The expected results after an operation to remove the stomach
In the results of the operation is influenced by many factors, including the overall health of the patient, stage of the disease, and others. In Oncology at the initial stage of survival for five years after surgery 90%. It may be possible to conduct the usual way and quality of life, of course, when you make some restrictions.