Do not be subjective with early signs of stomach cancer

From a particularly complicated real case, doctors recommend that people absolutely must not be subjective with the early signs of stomach cancer.

Successful endoscopic surgery for gastric cancer in a patient with complex underlying pathology.

Patient NNH, 60 years old, Hanoi , was admitted to the Center for Hepatobiliary and Digestive Surgery - Central Hospital for Tropical Diseases in a state of prolonged fatigue, anorexia, poor eating and significant weight loss, weighing only about 47-50kg.

According to his family, Mr. H. has many complex underlying diseases including HIV, which has been treated with ARVs and has been stable since 2002, a history of cured hepatitis C, chronic kidney failure and high blood pressure requiring daily medication. His thin body, poor immunity and poor nutrition have caused the patient to fall into a state of exhaustion, significantly increasing the risk of major surgery.

Endoscopy and biopsy results at the hospital determined that the patient had gastric adenocarcinoma, which contained signet ring cells – a highly malignant form of cancer that often progresses rapidly and spreads easily.

It is worth noting that stomach cancer in the early stages often has no typical symptoms, only causing bloating, indigestion, heartburn, dull pain in the epigastric region, which is easily confused with common gastritis, so patients are often subjective. As the disease progresses, patients begin to feel full early, lose weight, and have prolonged anemia - these are also the symptoms that Mr. H. encountered. In the late stages, a hard mass can be felt in the upper abdomen or left supraclavicular lymph nodes can be swollen, but at that time treatment becomes much more difficult.

Successful endoscopic surgery helps the patient overcome the crisis.

BSCKII Nguyen Thanh Son - Center for Hepatobiliary - Digestive Surgery said: "When admitted, the patient was weak, had poor appetite, and had reduced organ function, so the risk of complications during and after surgery was very high. However, if delayed, the tumor could invade deeper or cause obstruction and bleeding, making the patient no longer eligible for surgery. Therefore, intervention at the present time is necessary to improve the prognosis.
For patients with many underlying diseases like that, we have to consider each treatment indication very carefully. Because HIV patients have a higher risk of infection, the wound healing time is slower. Meanwhile, kidney and cardiovascular diseases make anesthesia and post-operative resuscitation especially sensitive. But after a multidisciplinary consultation - including hepatobiliary and digestive surgery, resuscitation, infectious diseases and anesthesia, we agreed to choose laparoscopic surgery to remove 3/4 of the stomach and dissect the lymph nodes, this is the fundamental treatment method for stomach cancer without distant metastasis.

During the surgery, the surgical team noted a tumor in the lesser curvature of the stomach, measuring about 2 cm. Although not too large, its proximity to large blood vessels and the hepatico-gastric ligament required extremely meticulous dissection to avoid bleeding. The biggest difficulty was the patient's weak physical condition, thin stomach tissue, fragile blood vessels, and atrophied stomach due to prolonged fasting, which limited the space for endoscopic manipulation. The team had to operate the instrument in a narrow field of view, carefully measuring every millimeter when dissecting near the left gastric vessel, while controlling the amount of bleeding during each surgical phase.

The surgery was performed entirely by endoscopy, using a stapler system to cut the diseased stomach and reconnect the stomach and intestines. The incision and the anastomosis were checked for tightness, ensuring no leakage or bleeding. Despite facing many risks, the surgery was successful, minimizing blood loss and no complications occurred during the surgery.

Doctor Son affirmed that laparoscopic surgery has many outstanding advantages compared to open surgery; less pain, early return to movement and eating, reduced risk of infection, postoperative intestinal obstruction and shortened hospital stay. Meanwhile, it still ensures the requirement of radical cancer eradication and removal of lymph nodes according to the correct procedure. This is a particularly important factor for patients with many underlying diseases.

From this case, Dr. Son recommends that people should not be subjective with prolonged symptoms such as loss of appetite, bloating, unexplained weight loss or dull pain in the epigastric region, which could be early signs of stomach cancer. People with chronic diseases need to be examined regularly to detect abnormalities early, because if detected early, the chance of successful treatment will be much higher.

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Source: https://baolaocai.vn/khong-chu-quan-voi-cac-dau-hieu-som-cua-ung-thu-da-day-post886863.html