Our Summary

This research looks at different methods of performing total gastrectomy (removal of the stomach) on patients with gastric adenocarcinoma (a type of stomach cancer). The study used national cancer data to compare the outcomes of traditional open surgery with minimally invasive procedures (like robotic or keyhole surgery).

The results showed that more than 70% of patients had an open total gastrectomy, while less than 30% had minimally invasive surgery. It was also found that minimally invasive surgery was more common in academic and high-volume medical centers.

The study compared the two methods of surgery, taking into account factors like patient characteristics, tumor specifics, and the type of facility where the procedure was performed. The comparison showed that the outcomes of both methods were almost identical, in terms of overall survival rates, surgical margins (the area of healthy tissue removed along with the tumor), readmission rates, and mortality rates within 90 days of surgery.

However, the study also found that patients who had minimally invasive surgery had shorter hospital stays (median of 9 days compared to 10 days for open surgery). This suggests that minimally invasive surgery could offer similar outcomes to traditional surgery, but with the added benefit of a quicker recovery time for patients.

FAQs

  1. What types of surgeries were compared in this study for the treatment of gastric adenocarcinoma?
  2. What were the main findings of the study comparing traditional open surgery and minimally invasive procedures for gastric adenocarcinoma?
  3. Does minimally invasive surgery for gastric adenocarcinoma offer any benefits over traditional open surgery according to this study?

Doctor’s Tip

A helpful tip a doctor might tell a patient about gastrectomy is to discuss with their healthcare team the possibility of minimally invasive surgery as it may lead to a shorter hospital stay and quicker recovery compared to traditional open surgery. It is important for patients to be informed about all their options and to work with their medical team to determine the best approach for their individual case.

Suitable For

Overall, patients with gastric adenocarcinoma who are recommended for gastrectomy are typically those with early-stage stomach cancer that has not spread to other parts of the body. The decision to undergo gastrectomy depends on factors such as the size and location of the tumor, the patient’s overall health and ability to tolerate surgery, and the expertise of the surgical team.

Patients who are younger, healthier, and have better overall fitness are more likely to be recommended for gastrectomy. Additionally, patients who have tumors that are localized to the stomach and have not spread to nearby lymph nodes or organs are also good candidates for gastrectomy.

It is important for patients to discuss the risks and benefits of gastrectomy with their healthcare team, including the potential for complications and long-term effects on digestion and nutrition. In some cases, other treatment options such as chemotherapy or radiation therapy may be recommended instead of or in addition to surgery.

Ultimately, the decision to undergo gastrectomy is a personalized one that should be made in consultation with a multidisciplinary team of healthcare providers, including surgeons, oncologists, and nutritionists.

Timeline

Before gastrectomy:

  1. Patient is diagnosed with gastric adenocarcinoma.
  2. Patient undergoes various tests and consultations to determine the best course of treatment.
  3. Patient and healthcare team decide on total gastrectomy as the best treatment option.
  4. Patient prepares for surgery by following pre-operative instructions and possibly undergoing chemotherapy or radiation therapy.

After gastrectomy:

  1. Patient undergoes total gastrectomy surgery, either through open surgery or minimally invasive surgery.
  2. Patient recovers in the hospital for a certain period of time, depending on the type of surgery and individual healing process.
  3. Patient may experience side effects such as pain, nausea, and changes in diet and digestion.
  4. Patient undergoes follow-up appointments and tests to monitor recovery and potential recurrence of cancer.
  5. Patient may need to make lifestyle changes to adjust to life without a stomach, such as eating smaller, more frequent meals and taking supplements.
  6. Patient may need ongoing support from healthcare professionals and possibly join support groups for individuals who have undergone gastrectomy.

What to Ask Your Doctor

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

  1. What are the different methods of performing a gastrectomy?
  2. What are the risks and benefits of each method?
  3. How will the choice of surgical method affect my recovery time and hospital stay?
  4. What is the expected outcome in terms of overall survival rates and potential complications?
  5. What is the experience of the medical team in performing gastrectomy procedures, especially minimally invasive surgery?
  6. Will I need any additional treatments or therapies after the surgery?
  7. What support services are available for patients undergoing gastrectomy, such as nutritional counseling or psychological support?
  8. How often will I need to follow up with my doctor after the surgery?
  9. Are there any lifestyle changes I should make before or after the surgery to improve my recovery and overall health?
  10. Can you provide me with any resources or information to help me better understand the procedure and what to expect?

Reference

Authors: Sweigert PJ, Eguia E, Nelson MH, Nassoiy SP, Knab LM, Abood G, Baker MS. Journal: Surgery. 2019 Oct;166(4):623-631. doi: 10.1016/j.surg.2019.05.041. Epub 2019 Jul 17. PMID: 31326190