Our Summary

This research study aimed to review scientific literature from the past 20 years (2001-2021) to understand the role of a specific surgical procedure, laparoscopic distal gastrectomy (LDG), in treating stomach cancer in elderly patients. The study noted changes in the aging general population and the increasing number of older, more vulnerable patients undergoing surgery for stomach cancer. The researchers concluded that LDG, a minimally invasive procedure, is not only comparable to traditional surgical methods in terms of effectiveness against cancer, but it also offers short-term benefits, particularly for elderly patients.

FAQs

  1. What is laparoscopic distal gastrectomy (LDG) and how is it used in treating stomach cancer in elderly patients?
  2. How does the effectiveness of LDG compare to traditional surgical methods in treating stomach cancer?
  3. What are the short-term benefits of LDG, particularly for elderly patients?

Doctor’s Tip

One helpful tip a doctor might tell a patient about gastrectomy is to follow a specific diet plan recommended by a dietitian post-surgery. This may include eating smaller, more frequent meals, avoiding certain foods that may be difficult to digest, and staying hydrated. It is important to follow these dietary guidelines to help with digestion and overall recovery after the procedure.

Suitable For

Patients who are typically recommended for gastrectomy include:

  1. Patients with stomach cancer: Gastrectomy is a common treatment for stomach cancer, especially in cases where the cancer has not spread beyond the stomach.

  2. Patients with large or high-risk stomach ulcers: In some cases, gastrectomy may be recommended for patients with large or high-risk stomach ulcers that do not respond to other treatments.

  3. Patients with certain benign stomach conditions: Gastrectomy may also be recommended for patients with benign stomach conditions that do not respond to medication or other non-surgical treatments.

  4. Patients with a family history of stomach cancer: Patients with a family history of stomach cancer may be recommended for gastrectomy as a preventive measure to reduce their risk of developing the disease.

  5. Patients with certain genetic conditions: Some genetic conditions, such as hereditary diffuse gastric cancer syndrome, may increase a person’s risk of developing stomach cancer and may warrant a gastrectomy as a preventive measure.

  6. Patients who are otherwise healthy enough to undergo surgery: Patients who are in overall good health and able to tolerate surgery may be recommended for gastrectomy as a treatment option for their stomach condition.

Timeline

Before gastrectomy:

  • Patient is diagnosed with stomach cancer through imaging tests, endoscopy, and biopsy.
  • Patient undergoes preoperative evaluations including blood tests, imaging scans, and consultations with healthcare providers.
  • Patient may need to undergo neoadjuvant therapy (chemotherapy or radiation) to shrink the tumor before surgery.

After gastrectomy:

  • Patient undergoes the gastrectomy procedure, which can be done through open surgery or minimally invasive techniques like laparoscopic distal gastrectomy.
  • Patient stays in the hospital for a few days to recover from the surgery and monitor for any complications.
  • Patient may experience side effects such as pain, nausea, and changes in diet and digestion.
  • Patient undergoes postoperative follow-up appointments and may need additional treatments like chemotherapy or radiation therapy.
  • Patient undergoes rehabilitation and dietary counseling to adjust to life without a stomach.
  • Patient may experience long-term changes in diet, digestion, and lifestyle, and may need ongoing support from healthcare providers.

What to Ask Your Doctor

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

  1. What type of gastrectomy procedure do you recommend for me (e.g. total gastrectomy, partial gastrectomy, laparoscopic distal gastrectomy)?
  2. What are the potential risks and complications associated with gastrectomy?
  3. How will the surgery impact my ability to eat and digest food?
  4. What is the expected recovery time after gastrectomy?
  5. Will I need any additional treatments (e.g. chemotherapy, radiation therapy) after the gastrectomy?
  6. How will gastrectomy affect my quality of life in the long term?
  7. Are there any alternative treatment options to gastrectomy that I should consider?
  8. What is your experience and success rate with performing gastrectomy procedures?
  9. How often will I need follow-up appointments after the gastrectomy?
  10. Are there any specific dietary or lifestyle changes I should make before or after the surgery to optimize my outcomes?

Reference

Authors: Pappalardo V, Galli F, Rausei S. Journal: Minerva Surg. 2023 Apr;78(2):173-182. doi: 10.23736/S2724-5691.22.09815-X. Epub 2023 Jan 18. PMID: 36651504