Our Summary

This research paper discusses the recent advancements in the surgical techniques used to treat stomach cancer, focusing mainly on minimally invasive methods like laparoscopic and robot-assisted surgeries. These advancements are particularly significant in Asia, where stomach cancer rates are ten times higher than in Europe. The paper reviews various ways to rebuild the digestive tract after a gastrectomy (surgery to remove part or all of the stomach), from traditional methods to newer techniques like double tract reconstruction. It also explores the possibility of preserving some stomach function through partial gastrectomy. The paper shares the latest research and technological advancements in the field, emphasizing the growing role of laparoscopic and robot-assisted surgeries.

FAQs

  1. What are the recent advancements in surgical techniques for treating stomach cancer?
  2. What is double tract reconstruction and how does it help in rebuilding the digestive tract after a gastrectomy?
  3. How does partial gastrectomy help in preserving some stomach function?

Doctor’s Tip

One helpful tip a doctor might tell a patient about gastrectomy is to follow a strict post-operative diet plan. This may include eating smaller, more frequent meals, avoiding certain foods that may cause discomfort or digestive issues, and staying hydrated. It is important for patients to work closely with their healthcare team to develop a personalized diet plan that meets their nutritional needs and promotes healing after surgery. Additionally, patients should be aware of potential long-term complications of gastrectomy, such as vitamin deficiencies, and work with their healthcare team to monitor and address any issues that may arise.

Suitable For

Patients who are typically recommended for gastrectomy include those with:

  1. Stomach cancer: Gastrectomy is often recommended as a treatment for stomach cancer, especially in cases where the cancer has not spread beyond the stomach.

  2. Peptic ulcers: In some cases, gastrectomy may be recommended for patients with severe or recurrent peptic ulcers that do not respond to other treatments.

  3. Gastric outlet obstruction: Gastrectomy may be recommended for patients with gastric outlet obstruction, a condition in which the opening between the stomach and the small intestine becomes blocked.

  4. Stomach polyps: Gastrectomy may be recommended for patients with large or symptomatic stomach polyps that cannot be removed through other methods.

  5. Inherited conditions: Some inherited conditions, such as hereditary diffuse gastric cancer (HDGC), may require gastrectomy as a preventive measure.

  6. Severe obesity: In some cases, gastrectomy may be recommended as a treatment for severe obesity, as part of a weight loss surgery procedure.

Overall, the decision to recommend gastrectomy for a patient is made based on a variety of factors, including the underlying condition, the stage of the disease, the patient’s overall health, and their individual preferences. It is important for patients to discuss the potential risks and benefits of gastrectomy with their healthcare provider to make an informed decision about their treatment options.

Timeline

Before gastrectomy:

  1. Patient may experience symptoms of stomach cancer such as abdominal pain, bloating, nausea, and weight loss.
  2. Patient undergoes diagnostic tests such as endoscopy, CT scan, and biopsy to confirm the presence of stomach cancer.
  3. Patient consults with a surgical oncologist to discuss treatment options, including the possibility of a gastrectomy.
  4. Patient undergoes pre-operative evaluations and tests to assess their overall health and fitness for surgery.

After gastrectomy:

  1. Patient undergoes a gastrectomy procedure to remove part or all of the stomach.
  2. Patient may experience post-operative pain, nausea, and difficulty eating initially.
  3. Patient is closely monitored in the hospital for any complications or signs of infection.
  4. Patient begins a gradual transition to a liquid diet followed by a soft diet to allow the digestive system to adapt to the changes.
  5. Patient may require nutritional support and counseling to ensure adequate nutrient intake.
  6. Patient undergoes regular follow-up appointments with their healthcare team to monitor their recovery and adjust their diet and medications as needed.
  7. Patient may experience long-term changes in their eating habits, digestion, and overall quality of life following a gastrectomy.

What to Ask Your Doctor

Some questions a patient should ask their doctor about gastrectomy include:

  1. What are the benefits and risks of a gastrectomy surgery for my specific condition?
  2. What type of gastrectomy procedure will be performed (partial, total, laparoscopic, robot-assisted, etc.)?
  3. What can I expect during the recovery period after the surgery?
  4. Will I need any additional treatments or therapies after the gastrectomy?
  5. How will my diet and eating habits need to change after the surgery?
  6. What are the potential long-term effects or complications of a gastrectomy?
  7. How will the surgery affect my digestive function and quality of life?
  8. What are the chances of the cancer recurring after the gastrectomy?
  9. Are there any alternative treatments or procedures that could be considered instead of a gastrectomy?
  10. How experienced is the surgical team in performing gastrectomy procedures, and what is the success rate of the surgery in their practice?

Reference

Authors: Weber MC, Berlet M, Novotny A, Friess H, Reim D. Journal: Chirurg. 2021 Jun;92(6):506-514. doi: 10.1007/s00104-020-01350-0. Epub 2021 Jan 26. PMID: 33496813