Our Summary

This research paper explores the best method for removing middle and lower-third stomach cancer. Two methods were compared: distal gastrectomy (DG), which removes part of the stomach, and total gastrectomy (TG), which removes the entire stomach. The researchers looked at various studies, including 4 randomized controlled trials and 7 retrospective cohort studies, involving 3554 patients in total. They found that the TG method had a higher rate of complications after surgery, including problems with the area where the stomach was reattached, wound complications, abscesses in the abdominal cavity, and death. However, there was no significant difference in the rate of cancer coming back or cancer-related death between the two methods. The 5-year survival rate was better for the DG method, but there was no significant difference when looking at specific stages of cancer. The study concluded that DG is the better surgical method for this type of cancer in early and locally advanced stages, as it has better short-term outcomes and similar long-term prognosis, as long as the cancer hasn’t spread to the area where the stomach is removed.

FAQs

  1. What are the two methods of removing middle and lower-third stomach cancer compared in this research paper?
  2. What complications were found to have a higher rate with the Total Gastrectomy method?
  3. Is there a significant difference in the rate of cancer recurrence or cancer-related death between distal gastrectomy and total gastrectomy?

Doctor’s Tip

A doctor might tell a patient undergoing gastrectomy to follow a nutritious diet and maintain a healthy weight to support recovery and overall health. They may also recommend regular exercise to help with digestion and prevent complications such as blood clots. It’s important for patients to closely follow their post-operative care instructions and attend all follow-up appointments to monitor for any potential issues.

Suitable For

Patients who are typically recommended for gastrectomy include those with:

  1. Stomach cancer: Gastrectomy is commonly recommended for patients with stomach cancer that has not spread to other organs. It may be used as the primary treatment or in conjunction with other treatments such as chemotherapy or radiation therapy.

  2. Gastric ulcers: Gastrectomy may be recommended for patients with severe or recurrent gastric ulcers that do not respond to medication or other treatments.

  3. Stomach polyps: Gastrectomy may be recommended for patients with large or precancerous stomach polyps that cannot be removed through other methods such as endoscopy.

  4. Gastrointestinal stromal tumors (GISTs): Gastrectomy may be recommended for patients with GISTs located in the stomach that are too large or have spread to other organs.

  5. Refractory gastroparesis: Gastrectomy may be recommended for patients with severe gastroparesis that does not improve with medication or other treatments.

  6. Inflammatory conditions: Gastrectomy may be recommended for patients with severe inflammatory conditions of the stomach such as refractory gastritis or autoimmune gastritis.

It is important for patients to discuss their individual case with a healthcare provider to determine if gastrectomy is the best treatment option for their specific condition.

Timeline

Before gastrectomy:

  1. Diagnosis of middle and lower-third stomach cancer through various tests such as endoscopy, biopsy, and imaging scans.
  2. Consultation with a multidisciplinary team of healthcare professionals to discuss treatment options, including surgery.
  3. Preoperative preparations such as imaging scans, blood tests, and nutritional counseling.
  4. Discussion of potential risks and benefits of gastrectomy with the surgical team.

After gastrectomy:

  1. Hospitalization for the surgery, which can vary in length depending on the type of gastrectomy performed.
  2. Recovery period in the hospital, which may involve pain management, monitoring for complications, and starting a liquid diet.
  3. Transition to a soft diet and eventually back to a regular diet over time.
  4. Follow-up appointments with the surgical team to monitor healing, address any complications, and discuss ongoing care.
  5. Potential long-term side effects of gastrectomy, such as changes in diet, nutritional deficiencies, and gastrointestinal issues.
  6. Ongoing surveillance for cancer recurrence through regular imaging scans and follow-up appointments with the oncology team.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with a gastrectomy procedure?
  2. How will a gastrectomy affect my digestive system and ability to eat and digest food?
  3. What is the recovery process like after a gastrectomy and how long will it take to fully recover?
  4. Will I need to make any changes to my diet or lifestyle after a gastrectomy?
  5. How often will I need to follow up with my doctor after the procedure?
  6. What are the chances of the cancer coming back after a gastrectomy?
  7. Are there alternative treatments or surgical options available for my condition?
  8. How experienced is the surgical team in performing gastrectomy procedures?
  9. What support services are available to help me cope with the physical and emotional challenges of undergoing a gastrectomy?
  10. Can you provide me with more information about the specific type of gastrectomy that will be performed and why it is recommended for my condition?

Reference

Authors: Li Z, Bai B, Xie F, Zhao Q. Journal: Int J Surg. 2018 May;53:163-170. doi: 10.1016/j.ijsu.2018.03.047. Epub 2018 Mar 27. PMID: 29602012