Gastric Cancer Surgery

Gastric cancer surgery removes part or all of the stomach together with the surrounding lymph nodes, and then reconnects the digestive tract. For stomach cancer that has not spread to distant organs, it is the central part of curative-intent treatment, usually combined with chemotherapy before and after.

The aim is complete removal of the tumour with clear margins and accurate staging from the nodes. Surgery changes how you eat for life. It is not offered when cancer has spread to distant sites, where it does not improve outcomes.

What Gastric Cancer Surgery involves

Staging comes first: gastroscopy with biopsies, CT, often endoscopic ultrasound, and a staging laparoscopy to look for small deposits on the abdominal lining that scans miss. Most people with anything beyond an early tumour then receive about 8 weeks of chemotherapy. At the operation, the surgeon removes the lower two thirds of the stomach for tumours near the outlet, or the entire stomach for tumours higher up or of diffuse type, together with the fatty omentum and the lymph node groups along the stomach's arteries, known as a D2 lymphadenectomy. Continuity is restored by bringing up a loop of small intestine and joining it to the stomach remnant or to the oesophagus in a Roux-en-Y arrangement.

Who is a good candidate for Gastric Cancer Surgery?

Decisions are made by a tumour board and depend on the stage, the tumour's position and your nutritional state and fitness.

• Stomach cancer confined to the stomach and regional nodes on staging
• People fit enough for major surgery, ideally after pre-operative chemotherapy
• Tumours causing bleeding or blockage, where surgery may also relieve symptoms
• Carriers of a CDH1 gene mutation considering preventive total gastrectomy, after specialist genetic counselling

Es ist normalerweise nicht die richtige Wahl, wenn:

• Very early cancers limited to the lining, which can often be removed by endoscopic submucosal dissection without surgery
• Cancer that has spread to the liver, the abdominal lining or distant nodes
• Severe malnutrition or poor heart and lung function until improved
• People who are unable to accept the lifelong dietary changes and follow-up

Technikoptionen

• Subtotal (distal) gastrectomy: Keeps the upper part of the stomach. Preferred when margins allow, as eating is easier afterwards.
• Total gastrectomy: Removes the whole stomach; the oesophagus is joined to the small bowel.
• D2 lymphadenectomy: The standard extent of node removal in specialist centres.
• Laparoscopic or robotic gastrectomy: Keyhole surgery with oncological results comparable to open surgery in trials, mainly for distal tumours in experienced centres.
• Endoscopic submucosal dissection: Removal through the gastroscope for selected early cancers.
• Perioperative chemotherapy: Commonly the FLOT regimen, 4 cycles before and 4 after surgery.

Was passiert während Ihrer Behandlung

The operation takes 3 to 5 hours under general anaesthetic with an epidural or nerve blocks. You may spend the first night in a high-dependency unit. Sips of fluid start within a day or two, building up to soft food in small portions. The hospital stay is typically 7 to 10 days if recovery is uncomplicated.

Vorbereitung auf Ihre Reise

Plan for 3 to 4 weeks for the operation alone in Istanbul. Your surgeon reviews photographs and your medical history before you book, and you meet in person the day before surgery for examination, marking and consent with a professional interpreter.

• Stoppen Sie das Rauchen und Nikotin mindestens vier Wochen vor und nach der Operation; es ist die größte vermeidbare Ursache von Wundproblemen
• Erzählen Sie dem Team von allen Medikamenten und Ergänzungen, die Sie einnehmen; Blutverdünner, einige Kräuterprodukte und Hormonbehandlungen müssen möglicherweise auf Anraten Ihres Arztes unterbrochen werden
• Vereinbaren Sie, dass jemand mit Ihnen reist oder erreichbar ist, und halten Sie die ersten Tage zu Hause frei von Arbeit und Heben
• Buchen Sie einen veränderlichen Rückflug; Ihr Chirurg bestätigt, wenn Sie fit sind

Genesung und Ergebnisse

Expect to eat 6 to 8 small meals a day, to chew well and to separate drinks from food. Weight loss of around 10 percent is common in the first months, and a dietitian is an important part of the team. Dumping syndrome, with sweating, faintness or diarrhoea after sugary food, improves with changes in diet. After total gastrectomy you need vitamin B12 injections for life, and iron and calcium levels are monitored. Most people take 2 to 3 months to return to work. Post-operative chemotherapy begins at about 6 to 10 weeks, if you are fit enough.

• Back to everyday activity: 2 to 3 months
• When results show: Pathology in 1 to 2 weeks
• How long they last: Follow-up for at least 5 years; lifelong nutritional monitoring

Sicherheit, Risiken und Revisionspolitik

Gastrectomy is a major operation, and results are better in centres that perform it regularly.

• Leak from the join between oesophagus or stomach and bowel, a serious complication requiring drainage, stenting or re-operation
• Leak from the closed end of the duodenum
• Chest infection and blood clots
• Bleeding or abdominal abscess
• Pancreatic leak after extensive node dissection
• Long-term weight loss, dumping syndrome, bile reflux and diarrhoea
• Vitamin B12 and iron deficiency, and bone thinning
• Narrowing of the join that needs endoscopic stretching

Jeder schriftliche Vorschlag wird durch Clinic-Y gibt an, was die Klinik abdeckt, wenn eine Korrektur erforderlich ist. Fragen Sie danach, bevor Sie buchen, nicht danach.

Cost of Gastric Cancer Surgery in Türkiye

Clinic-Y does not publish a single price for Gastric Cancer Surgery, because the honest figure depends on your case. What moves it:

• Subtotal versus total gastrectomy, and open versus keyhole or robotic approach
• Nächte auf der Intensivstation und auf der Station
• Staging laparoscopy, scans and pathology
• Nutritional support such as feeding tubes and supplements
• Chemotherapy before and after, which is a separate course

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