Our Summary

This research paper compares two different types of surgeries for advanced stomach cancer: laparoscopic gastrectomy (LGD2), where the surgery is performed through small incisions using a camera, and open gastrectomy (OGD2), where a large incision is made. The researchers analyzed various studies conducted between 2000 and 2017.

They found that LGD2 had several advantages over OGD2. It resulted in less blood loss during surgery, shorter recovery times, less need for pain medication, and a shorter hospital stay. Importantly, both surgeries were found to be equally effective in terms of how many lymph nodes they could remove (which is important for preventing the spread of cancer), recurrence of the tumor, and survival rates over three to five years. However, LGD2 took longer to perform than OGD2.

In conclusion, even though it takes more time and skill to perform, LGD2 seems to be a better option for treating advanced stomach cancer as it is less invasive and has the same effectiveness as OGD2.

FAQs

  1. What are the main differences between laparoscopic gastrectomy (LGD2) and open gastrectomy (OGD2)?
  2. What advantages does LGD2 have over OGD2 in treating advanced stomach cancer?
  3. Are there any differences in effectiveness or survival rates between LGD2 and OGD2?

Doctor’s Tip

A helpful tip a doctor might give a patient about gastrectomy is to discuss with their healthcare team the option of laparoscopic gastrectomy (LGD2) as it has been shown to have several advantages over open gastrectomy (OGD2) for treating advanced stomach cancer. It is less invasive, results in less blood loss, shorter recovery times, less need for pain medication, and a shorter hospital stay. It is important to weigh the pros and cons of each type of surgery and make an informed decision with the guidance of your medical team.

Suitable For

Patients with advanced stomach cancer who are recommended for gastrectomy may include those who have not responded to other forms of treatment such as chemotherapy or radiation therapy, those who have a tumor that is localized to the stomach and has not spread to other organs, and those who are otherwise healthy and able to undergo surgery. Additionally, patients with certain types of stomach cancer, such as gastric adenocarcinoma, may be recommended for gastrectomy as part of their treatment plan. Ultimately, the decision to undergo gastrectomy will depend on a variety of factors including the stage and location of the cancer, the patient’s overall health and ability to tolerate surgery, and the potential risks and benefits of the procedure.

Timeline

Before gastrectomy:

  • Patient undergoes various tests and scans to diagnose stomach cancer
  • Patient meets with a surgeon to discuss treatment options, including gastrectomy
  • Patient may undergo neoadjuvant chemotherapy or radiation therapy to shrink the tumor before surgery

During gastrectomy:

  • Surgery is performed either laparoscopically (LGD2) or through an open incision (OGD2)
  • Surgeon removes part or all of the stomach, depending on the extent of the cancer
  • Lymph nodes may also be removed to prevent the spread of cancer

After gastrectomy:

  • Patient wakes up in the recovery room and is monitored closely for complications
  • Patient may experience pain, nausea, and difficulty eating in the days following surgery
  • Patient is gradually transitioned to a liquid diet, then soft foods, and eventually a regular diet
  • Patient may need to take vitamin supplements to prevent nutrient deficiencies
  • Patient undergoes regular follow-up appointments and scans to monitor for recurrence of the cancer

Overall, gastrectomy can be a challenging and life-changing experience for patients, but it can also offer a chance for a cure or long-term remission from stomach cancer.

What to Ask Your Doctor

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

  1. What are the risks and potential complications associated with gastrectomy surgery?
  2. How long will the recovery process be after the surgery, and what can I expect during this time?
  3. Will I need to make any changes to my diet or lifestyle after the surgery?
  4. What are the chances of the cancer recurring after the surgery?
  5. How many lymph nodes will be removed during the surgery, and how does this impact my prognosis?
  6. What are the potential long-term side effects of gastrectomy surgery?
  7. Will I need any additional treatments, such as chemotherapy or radiation therapy, after the surgery?
  8. What is the success rate of gastrectomy surgery for treating advanced stomach cancer?
  9. How experienced are you in performing gastrectomy surgery, and what is your success rate?
  10. Are there any alternative treatment options available for my condition, and how do they compare to gastrectomy surgery in terms of effectiveness and risks?

Reference

Authors: Mitrousias AS, Makris MC, Zani JR, Kornaropoulos M, Tsilimigras DI, Chrysikos D, Michalopoulos NV, Spartalis E, Moris D, Felekouras E. Journal: J BUON. 2019 May-Jun;24(3):872-882. PMID: 31424636