About stomach cancer, its main symptoms and diagnostic methods, as well as initial information about the methods of treatment can be found in articles on our website in a special rubric. Now it is offered to learn more about the methods of treatment - this series of articles will be devoted to surgery of stomach cancer. In the first article attention will be paid to operations on the stomach with cancer.
Resection of the stomach in cancer
As already mentioned in the previous cycle of articles, one of the most radical and effective methods of treatment remains gastrectomy in cancer, or in other words, the removal operation. In medical practice, there are three main types of interventions used depending on the location of the tumor:
- subtotal or partial resection is used when the tumor is located in the lower half of the organ;
- gastrectomy( total resection) is recommended for lesions of the cardial, pyloric or bottom;
- proximal resection - performed when the tumor is located in the upper part of the organ.
As a result of subtotal resection, 65-80% of the whole organ is removed, while the smaller part is sewn smaller, and with the total or gastrectomy associated with complete removal of the stomach in cancer, the esophagus is directly stitched with the small intestine, which leads to hardrules in the future nutrition of the patient. Recently, in the surgery of stomach cancer, the method of creating a small reservoir with removal of the stomach is increasingly being used( in its place a small reservoir is placed( instead of the esophagus directly connected with the intestine). As a result of this approach, the postoperative period improves significantly, the patient is less worriedheartburn, and his life is improved qualitatively after resection
In some, especially neglected cases, combinations of the above types of interventions are used, and, as a rule,except for the stomach, the neighboring organs affected by cancer cells are partially removed, and the lymphatic system is also affected by the cancer, and therefore, in the surgical treatment of stomach cancer, a procedure is used to remove a part of the affected lymphatic system-lymphadenectomy, since this processis considered the least traumatic for the body as a whole, and rehabilitation is quicker and easier than with traditional intervention. This is facilitated by the lack of the need to install drains in the retroperitoneal space( laparoscopic lymph dissection helps avoid lymph flow).
It should be noted that in the case of detection of multiple metastases to neighboring organs, surgical interventions are not advisable, however, palliative are shown. An example of such an operation is palliative resection, in which excision of the tumor and some metastases is performed, which leads to alleviation of the patient's suffering and allows prolonging his life, albeit for a short time.
In surgical treatment, it is possible to perform an incision with a large incision in the vertical plane of the abdomen, for example, in the case of gastrectomy with cancer, or with a small incision, usually used in the early stages of the disease, when the size of the tumor is not yet so great. In the latter case, miniature instruments are inserted through a small incision, and a part of the organ is removed. Due to the small size of the incision during laparoscopy in gastric cancer, the process is less marked and the postoperative period is markedly reduced.
Any procedure for removal requires careful preparation and mandatory in-patient follow-up of the patient in the postoperative period. At the stage of preparation for surgery, the patient takes vitamins, and also takes a course of restorative drugs. Also at this stage, additional studies are carried out by diagnostic methods considered in the previous cycle of articles, the purpose of which is to obtain an actual picture of the disease. In special cases, preoperative radiation and chemical therapy may be used.
After removal, the patient must be given antibiotics, as well as anesthetics to reduce discomfort, it is possible to use a dropper. After the doctor's permission, the patient starts taking liquid food at first, gradually introducing ground foods( soups, cereals, etc.).
Based on observations and statistical data, it can be concluded that the removal of the stomach in cancer leaves a fairly optimistic prediction after the procedure. For patients with the advanced form of cancer, removal of the stomach - the prospect is not so rosy. However, various therapies, such as chemical and radiation therapy, are used to support the patient's life. But this will be discussed in the next article. In conclusion, it should be noted that the pledge of successful intervention in the removal of organs - compliance with the recommendations of doctors and a conscious attitude to their own health.