GASTRIC TUMOR

Prof. Dr. Mansab Ali

HOD, General Surgery Department
 LEARNING OBJECTIVES
 Describe clinical features of Ca
Stomach.
 Enlist the various methods of
investigation in Ca stomach.
 Enlist the stages of Ca stomach.
 Describe complications of gastrectomy.
 Describe different surgical treatment
options for Ca stomach.
 Describe management plan of CA
stomach.
Describe clinical features of Ca
stomach.
 Weight Loss
 Appetite Loss
 Haemetesis
 Malena
 Mass Abdomen
 Ascities
 Metastatic Disease
Enlist the various methods of
investigation in Ca stomach.
 Barium Meal and Follow Through
 Endoscopy & Biopsy
 CT Scan Abdomen
 Endoscopy Ultrasonography
 PET Scan
 Laparoscopy
 USG Abdomen
Enlist the stages of Ca stomach.
Describe complications of
gastrectomy.
 Dumping Syndrome
 Pernicious Anemia / Nutritional Deficiencies
 Dysphagia
Describe different surgical treatment
options for Ca stomach.
 Gastrectomy
 Total Gastrectomy
 Sub Total Gastrectomy
 Lymph node dissection
 Palliative treatment
Describe management plan of CA
stomach.
 Gastrectomy
 Total Gastrectomy
 Sub Total Gastrectomy
 Lymph node dissection
 Palliative treatmentS
 TAKE HOME MESSAGE
●● Gastric cancer is one of the most common causes of cancer death in the world
●● The outlook is generally poor, owing to the advanced stage of the tumour at
presentation
●● Better results are obtained in Japan, which has a high population incidence,
screening programmes and a high quality surgical treatment
●● The etiology of gastric cancer is multifactorial, but H. pylori is an important
factor for distal but not proximal gastric cancer
●● Early gastric cancer is associated with very high cure rates
●● Gastric cancer can be classified into intestinal and diffuse types, the latter
having a worse prognosis
●● In western resource-rich countries, proximal gastric cancer is now more
common than distal cancer and is usually of the diffuse type
●● Spread may be by lymphatics, blood, transcoelomic or direct, but distant
metastases are uncommon in the absence of lymph node involvement
●● The treatment of curable cases is by radical surgery and removal of the second
tier of nodes (around the principal arterial trunks) may be advantageous
●● Gastric cancer is chemosensitive and chemotherapy improves survival in
patients having surgery for the condition and in advanced disease
Summary box 63.5
Gastric outlet obstruction
●● Gastric outlet obstruction is most commonly associated with
longstanding peptic ulcer disease and gastric cancer
●● The metabolic abnormality of hypochloraemic alkalosis is
usually only seen with peptic ulcer disease and should be
treated with isotonic saline with potassium
●● Endoscopic biopsy is essential to determine whether the
cause of the problem is malignancy
●● Aggressive medical therapy for peptic ulcer disease often
leads to resolution
●● Endoscopic dilatation of the gastric outlet may be effective in
less severe cases of benign stenosis
●● Operation is frequently required, with a drainage procedure
being performed for benign disease and appropriate
resectional surgery if malignant
THANKS