The challenge of surgical removal of cancerous stomach for people with severe scoliosis

A 71-year-old female patient with stomach cancer had a 60-degree scoliosis. The patient was thin and weak, only about 1.4m tall and weighed 32kg. She had severe scoliosis due to a history of spinal trauma, with a 60-degree scoliosis, making it difficult for her to move around and perform daily activities.

After consultation, doctors at the Department of Digestive Surgery, 108 Military Central Hospital decided to apply endoscopic surgery to treat stomach cancer for the patient. However, the surgery faced many major challenges.

Dr. Pham Van Hiep, Department of Gastrointestinal Surgery, 108 Central Military Hospital, said that due to the condition of the spine and small body, when lying down, the abdominal area intended for surgery becomes extremely narrow, making it almost impossible to put the hand into the operating field. The operating space is severely limited because the stomach is located behind the ribs, and is also obscured by other organs such as the liver and colon.

To perform the surgery, doctors had to carefully calculate the location of trocars – ports to insert surgical instruments into the body – to ensure precise manipulation in difficult conditions.

Dr. Hiep said the surgical team had to place trocars in special locations to be able to perform a complete laparoscopic surgery and remove the cancerous part of the stomach. The manipulation of instruments in a narrow space and being obscured by other organs caused the surgery to last about 4 hours.

Three days after surgery, the patient had fully recovered and was able to walk and eat normally. This is a very rare case of stomach cancer in a patient with severe scoliosis being successfully treated with endoscopic surgery, according to Dr. Hiep.

Gastrointestinal cancers are increasing and becoming a global problem, including stomach cancer. According to statistics from the World Cancer Organization (Globacan 2020), in Vietnam, each year more than 17,000 new cases of stomach cancer are recorded, occurring more in men than in women. The disease often progresses silently, with vague and atypical symptoms, so it is easily confused with other benign diseases.

Scoliosis is quite common, affecting about 0.5-1% of children. In 80% of cases, the cause is unknown. The rest may be due to infection, trauma, sitting in the wrong position, or having spinal deformities from the womb (congenital).

Source: https://nhandan.vn/thach-thuc-phau-thuat-cat-bo-phan-da-day-ung-thu-cho-nguoi-gu-veo-cot-song-nang-post869876.html