Our Summary

Stomach cancer is the third leading cause of cancer deaths worldwide. For patients who are potentially curable (those without cancer spread), there are two surgical options; laparoscopic surgery (small incisions and use of a camera) and open surgery (a large cut in the stomach). This study aimed to determine which option is better. The researchers looked at 13 trials involving 2,794 patients, comparing those who had the laparoscopic surgery and those who had open surgery. They found no significant difference in terms of short-term death rates, serious side effects, amount of blood transfused during surgery, length of hospital stay, and number of lymph nodes removed. However, they noted the evidence is of low quality and the results are not precise, meaning they can’t definitively say one surgery is better than the other. More high-quality research is needed to come to a firm conclusion.

FAQs

  1. What are the surgical options for potentially curable stomach cancer patients?
  2. What were the findings of the study comparing laparoscopic surgery and open surgery for stomach cancer?
  3. Why can’t the researchers definitively say which surgery is better for stomach cancer?

Doctor’s Tip

One important tip that a doctor might tell a patient about gastrectomy is to carefully follow post-operative instructions provided by their healthcare team. This may include dietary guidelines, activity restrictions, and medication management. It is also important to attend all follow-up appointments to monitor recovery and address any concerns or complications that may arise. Additionally, maintaining a healthy lifestyle, including regular exercise and a balanced diet, can help support overall recovery and long-term health after gastrectomy.

Suitable For

Patients who are typically recommended for gastrectomy include those with early-stage stomach cancer, precancerous conditions such as gastric dysplasia, and certain benign tumors of the stomach. Patients with advanced stomach cancer may also undergo gastrectomy as part of a treatment plan to remove as much of the cancer as possible. Additionally, patients with severe complications from conditions such as peptic ulcers or gastrointestinal bleeding may also require gastrectomy as a treatment option. Ultimately, the decision to recommend gastrectomy depends on the individual patient’s specific medical condition and overall health status.

Timeline

Before gastrectomy:

  • Patient is diagnosed with stomach cancer through imaging tests, biopsies, and blood tests
  • Patient undergoes preoperative evaluations to assess overall health and determine the best surgical approach
  • Patient may undergo chemotherapy or radiation therapy to shrink the tumor before surgery
  • Patient receives counseling and education about the procedure and potential side effects
  • Patient undergoes the gastrectomy surgery, either laparoscopic or open, to remove part or all of the stomach

After gastrectomy:

  • Patient may experience pain, nausea, and difficulty eating in the immediate postoperative period
  • Patient is monitored closely for complications such as infection, bleeding, or leakage from the surgical site
  • Patient undergoes a gradual recovery process, starting with a liquid diet and progressing to solid foods
  • Patient may require nutritional supplements or dietary modifications to compensate for reduced stomach capacity
  • Patient is followed up with regular check-ups and imaging scans to monitor for cancer recurrence
  • Patient may experience long-term side effects such as dumping syndrome, malabsorption, and nutritional deficiencies
  • Patient may undergo additional treatments such as chemotherapy or radiation therapy depending on the stage and aggressiveness of the cancer
  • Patient focuses on lifestyle modifications such as regular exercise, healthy eating, and avoiding tobacco and alcohol to reduce the risk of cancer recurrence or other complications.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with gastrectomy surgery?
  2. What is the recovery process like after gastrectomy surgery?
  3. How will my diet and eating habits need to change after gastrectomy surgery?
  4. Will I need any additional treatments or therapies after gastrectomy surgery?
  5. How often will I need to follow up with you after gastrectomy surgery?
  6. Are there any long-term effects or considerations I should be aware of after gastrectomy surgery?
  7. What is your experience with performing gastrectomy surgeries, and what is your success rate?
  8. How do you determine if laparoscopic surgery or open surgery is the best option for me?
  9. Can you explain the potential benefits of laparoscopic surgery versus open surgery for gastrectomy?
  10. Are there any specific guidelines or recommendations I should follow before and after gastrectomy surgery to optimize my outcome?

Reference

Authors: Best LM, Mughal M, Gurusamy KS. Journal: Cochrane Database Syst Rev. 2016 Mar 31;3(3):CD011389. doi: 10.1002/14651858.CD011389.pub2. PMID: 27030300