STOMACH CANCER SURGERY

General Information

DEFINITION-Removal of cancerous tissue (gastric carcinoma) in the stomach.

BODY PARTS INVOLVED-Stomach; small intestine.

REASONS FOR SURGERY-Cancer of the stomach.

SURGICAL RISK INCREASES WITH

• Adults over 60.
• Obesity; smoking; stress.
• Poor nutrition.
• Recent illness.
• Alcoholism or other chronic illness.
• Use of drugs such as: antihypertensives; muscle relaxants; tranquilizers; sleep inducers; insulin; sedatives; beta-adrenergic blockers; or cortisone.
• Use of mind-altering drugs, including: narcotics; psychedelics; hallucinogens; marijuana; sedatives; hypnotics; or cocaine.

What To Expect

WHO OPERATES-General surgeon.

WHERE PERFORMED-Hospital.

DIAGNOSTIC TESTS

• Before surgery: X-rays of gastrointestinal tract; blood and urine studies; endoscopy (See Glossary).
• During surgery: Laboratory examination of removed tissue by frozen section (See Glossary).
• After surgery: Blood studies; laboratory examination of removed tissue.

ANESTHESIA-General anesthesia by injection and inhalation with an airway tube placed in the windpipe.

DESCRIPTION OF OPERATION

• A tube is passed from the nose into the stomach to keep the stomach decompressed.
• An incision is made below the ribs.
• Abdominal muscles are cut or retracted, the peritoneum is opened and the stomach is isolated.
• The cancerous part of the stomach is cut free and removed. If the cancer has spread, the total stomach plus the spleen and nearby lymph nodes may be removed. The esophagus may be joined to the intestine for continued digestion ability.
• The remaining stump of stomach is joined to a loop of small intestine (usually the jejunum) to allow normal digestive flow.
• The peritoneum is closed and the muscles are sewn together. The skin is closed with sutures or clips, which usually can be removed about 10 days after surgery.

POSSIBLE COMPLICATIONS-Excessive bleeding; surgical-wound infection; incisional hernia; chronic diarrhea; malnutrition; dumping syndrome; ulcer disease.

AVERAGE HOSPITAL STAY-10 to 14 days.

PROBABLE OUTCOME-Expect complete healing of the surgical wound. Your doctor may recommend further treatment with radiation and anticancer drugs. Allow about 6 weeks for recovery from surgery.

Postoperative Care

† Move and elevate legs often while resting in bed to decrease the likelihood of deep--vein blood clots.

† You may use non--prescription drugs, such as acetaminophen, for minor pain.

† To help recovery and aid your well--

being, resume daily activities, including work, as soon as you are able.

• Resume driving 2 weeks after returning home. > Avoid vigorous exercise for 6 weeks after surgery.

DIET--Your doctor will prescribe a diet.

Call Your Doctor If

† Pain, swelling, redness, drainage or bleeding increases in the surgical area.

• You develop signs of infection: headache, muscle aches, dizziness or a general ill feeling and fever.
• You experience nausea, vomiting, constipation or abdominal swelling.
• New, unexplained symptoms develop. Drugs used in treatment may produce side effects.