Gastrectomy due to recurrence of cancer

Stomach cancer is one of the medical burdens of many countries around the world. It is the second leading cause of cancer death, after lung cancer. More than 90% of stomach cancers are carcinomas. Prognosis of gastric cancer is not good, the average 5-year survival rate is less than 20%, mainly due to delay in diagnosis. The incidence of stomach cancer is highest in East Asian countries such as China, Japan, and Korea. Gastric cancer appears to be the result of many combined factors, in which Helicobacter pylori is considered the main cause, in combination with host, environmental and other microbial factors.
Recurrent stomach cancer can appear early or late many years after the time of first primary cancer treatment. Many clinical cases of gastric cancer recurrence after decades have been reported. Most cases of gastric cancer with local recurrence include at the cutting apex or at the anastomosis site. Gastrectomy is the primary treatment of choice in patients with recurrent gastric cancer that has not spread to distant sites.

Similar to primary gastric cancer, surgical treatment of recurrent gastric cancer is not suitable for all patients. Gastrectomy for recurrent cancer is applied in the following cases:
Stomach cancer recurs at the stump site and has not spread to distant organs outside the abdomen. The liver, colon, body and tail of the pancreas may be involved in situ. Gastric bypass surgery should be used when stomach cancer invades one of the three organs mentioned above. Recurrent gastric cancer at the junction of the stomach and the colon without distant metastases to extra-abdominal viscera or with peritoneal metastases. Recurrent gastric cancers with multiple organ invasions, distant metastases, or late stages are not suitable candidates for gastrectomy.

The preferred treatment for recurrent gastric cancer is gastric bypass surgery. The performing surgeon must be experienced in gastrointestinal cancer because this is a complex surgery with many risks. The surgical team consists of the main surgeon, an assistant surgeon, an anesthesiologist and an anesthesiologist. Gastrectomy for recurrent gastric cancer is divided into two main categories: total gastrectomy or partial gastrectomy after gastrojejunostomy.

Total gastrectomy in recurrent gastric cancer is performed by an open pre-abdominal incision. The surgeon conducts abdominal exploration along the mid-white line above the navel, removes the old scar and carefully removes the intra-abdominal adhesions, observing the liver, stomach, gastric stump and ovaries if the patient is female. gender. The old gastric anastomoses were then removed from surrounding viscera and tissues before being resected along with the stomach, peritoneum, and adjacent lymph nodes. Restore gastrointestinal circulation by connecting the esophagus to the lower jejunum. Finally, the surgeon performed a thorough hemostasis, re-checked the abdomen and placed an abdominal drainage tube at the position below the liver to monitor the patient. Only cases where the tumor appeared more than 3cm from the coccyx with invasion into the head of the pancreas, the hepatic peduncle but did not extend far into the blood vessels supplying the colon from the inferior mesenteric artery and the superior mesenteric artery had the disease. indication for total gastrectomy.
Patients with recurrent gastric cancer who have previously undergone gastrojejunostomy, decide on the method of partial or total gastrectomy based on the location and characteristics of the recurrent tumor. The surgeon can perform a distal gastrectomy or the entire stomach, with lymph node dissection and re-establishment of gastrointestinal circulation.

Patients with recurrent gastric cancer who are indicated for gastrectomy should be closely monitored after treatment. Gastric bypass surgery is a major or complicated surgery, patients have to face many risks and complications such as:
Bleeding: Postoperative bleeding is a dangerous complication that surgeons often worry about. hesitate. Blood can come from any location such as the gastro-intestinal junction or blood vessels. In severe cases, massive bleeding affects the patient's general condition, requiring emergency surgery to stop bleeding. Patients need to be monitored the amount and color of fluid from the drainage system combined with blood count tests to promptly detect bleeding, assess severity and respond to treatment. . Intestinal obstruction: May appear as early as 72 hours after surgery, due to adhesion inflammation or abnormal movements of the bowel loops. Clinical symptoms such as abdominal pain, abdominal distension, and defecation after surgery should be monitored and evaluated. In some cases, patients have had bowel movements before but can still develop intestinal obstruction after surgery at a later stage. Intestinal obstruction after gastrectomy, if unresponsive to conservative treatment, requires early surgery. Anastomosis podium: This is a complication that occurs due to inadequate suture technique or anastomosis margin containing lesions. When complications of anastomosis occur, blood and digestive juices flow into the abdomen, which can cause localized or generalized peritonitis, more severe can lead to sepsis. Monitoring clinical symptoms and the nature of the drainage is necessary to promptly detect the fistula of the anastomosis. Surgical repair of anastomosis is indicated in severe cases that do not respond to conservative treatment.

Gastrointestinal cancer screening is a scientific and effective measure for early detection of gastrointestinal cancers (esophageal cancer, stomach cancer, colon cancer) and providing a good treatment plan. best. Currently, Vinmec International General Hospital has a package of screening and early detection of cancers of the gastrointestinal tract (esophagus - stomach - colon) combined with clinical and paraclinical examination to bring the most accurate results. maybe.
When screening for gastrointestinal cancer at Vinmec, you will receive:
Gastrointestinal specialty examination with an oncologist (by appointment). Gastroscopy and colonoscopy with an NBI endoscope with anesthesia. Peripheral blood count (laser counter). Automated prothrombin time test. Automated thrombin time test. Activated Partial Thromboplastin Time (APTT) test using an automated machine. General abdominal ultrasound To register for screening and treatment of gastrointestinal diseases at Vinmec International General Hospital, you can contact Vinmec Health System nationwide, or register for an online examination. HERE .
Recommended videos:


Things to know about cancer

SEE ALSO:
Esophageal - stomach cancer screening package Nutrition for patients with stomach cancer Stomach cancer surgery with advanced endoscopic techniques