43611 Excision, local; malignant tumor of stomach

Name of the Procedure:

Excision, local; malignant tumor of the stomach

• Common Name: Local excision of gastric cancer
• Medical Term: Partial gastrectomy for malignant neoplasm

Summary

A local excision of a malignant tumor in the stomach is a surgical procedure aimed at removing a cancerous growth from the stomach. This procedure involves the removal of the tumor along with some of the surrounding healthy tissue to ensure all cancer cells are excised.

Purpose

• Medical Condition: Malignant tumor of the stomach (gastric cancer)
• Goals: To remove cancerous tissue, reduce the spread of cancer, and improve the patient's chances of survival.

Indications

• Presence of a malignant tumor in the stomach confirmed by diagnostic imaging and biopsy
• Symptoms such as persistent abdominal pain, unintentional weight loss, nausea, or vomiting
• Patients diagnosed with early-stage gastric cancer
• Criteria: Suitable general health to undergo surgery

Preparation

• Instructions: Fasting for at least 8 hours prior to the procedure; arranging for postoperative care
• Assessments: Preoperative blood tests, imaging studies (CT scan or MRI), endoscopic evaluation, and possible biopsy
• Medications: Adjustments to current medications as advised by the healthcare provider; prophylactic antibiotics may be given

Procedure Description

1. Anesthesia: General anesthesia is administered.
2. Incision: A surgical incision is made in the abdomen to access the stomach.
3. Tumor Excision: The malignant tumor and some surrounding healthy tissue are carefully removed.
4. Closure: The remaining parts of the stomach are sutured together.
5. Completion: The incision is closed with sutures or staples, and a dressing is applied.

• Tools/Equipment: Surgical scalpel, sutures, surgical clamps, sterilized instruments, imaging guidance devices if necessary

Duration

The procedure typically takes between 2 to 4 hours, depending on the complexity and size of the tumor.

Setting

The local excision of a malignant stomach tumor is performed in a hospital setting, often in an operating room equipped for major surgeries.

Personnel

• Surgeon
• Anesthesiologist
• Surgical nurses
• Surgical assistants

Risks and Complications

• Common risks: Bleeding, infection, reaction to anesthesia
• Rare risks: Leakage at the site of sutures in the stomach, injury to adjacent organs, blood clots
• Management: Regular monitoring, antibiotics for infection, possible secondary surgery for complications

Benefits

• Expected Benefits: Removal of cancerous tissue, relief of symptoms, and potential cure if all cancerous cells are removed; improved prognosis
• Timeline: Benefits are realized once the patient recovers from surgery, typically within a few weeks to months

Recovery

• Post-procedure Care: Pain management with medications, dietary modifications to allow the stomach to heal, gradual reintroduction of solid foods.
• Instructions: Activity restrictions, wound care, avoidance of heavy lifting
• Recovery Time: Full recovery can range from several weeks to a few months; follow-up appointments to monitor healing and detect any recurrence of cancer

Alternatives

• Alternative Treatments: Chemotherapy, radiation therapy, less invasive endoscopic resection
• Pros and Cons:
  • Chemotherapy and radiation can be less invasive but may not be as effective in early-stage cancer.
  • Endoscopic procedures are minimally invasive but suitable only for very small tumors.

Patient Experience

• During the Procedure: The patient is under general anesthesia and will not feel anything.
• Post-Procedure: Patients may experience pain, discomfort, or nausea which can be managed with medication. The healing process involves dietary changes and gradual return to normal activities, ensuring to follow the medical team's guidance on recovery

Pain management typically includes prescribed pain relievers, and comfort measures such as adequate rest and a carefully managed diet are crucial for a smooth recovery.