Suffer from cardia gland cancer, be an operation?Or chemo before surgery?

2022-05-29 0 By

The author/henan province people’s hospital of gastrointestinal surgery Lisa, director of the end of 2021 on a Saturday morning, 1 / f, 17 in east henan province people’s hospital outpatient clinic, gastrointestinal surgery clinic just begin at 8 o ‘clock, a look of panic young directly into the clinic, in a hurry when it comes to “just 53 years old, his father at home checking gastroscope suddenly found the stomach,My father was the breadwinner of the family, and my mother and I didn’t know what to do.After much inquiry, I heard that you are not only a skillful doctor, but also a good man, so I came to see you this morning.”After admission, relevant auxiliary examinations were completed for the patient.For gastric tumor, we can divide into qualitative examination and quantitative examination.Qualitative examination is to see what disease, basically rely on pathological examination to achieve, it is to determine the gold standard of gastric cancer.Quantitative examination is to understand the severity of the disease, mainly relying on preoperative imaging examination and detection of tumor markers.The patient was diagnosed with adenocarcinoma of the cardia. CT indicated that the fundus of the stomach and the lateral wall of the lesser curvature of the stomach were thickened, and multiple enlarged lymph nodes were seen between the liver and stomach.Surgery for these patients?Or chemo before surgery?Therefore, after MDT discussion in Henan Provincial People’s Hospital for gastric cancer, neoadjuvant therapy for gastric cancer was decided to be performed before surgery.Therefore, according to the patient’s physical condition, auxiliary examination results and family economic situation, our team developed an individual neoadjuvant treatment plan for the patient.(CT report of 2021.12.5) (CT image of 2021.12.5) After two cycles of neoadjuvant chemotherapy, we re-examined CT and found that the tumor was smaller than before. After communication with the patient’s family, surgery was decided.On January 19, 2022, laparoscopic radical total gastrectomy was performed for the patient.Due to chemotherapy, the tumor tissue degeneration and necrosis greatly increased the difficulty of surgery, but our team still overcame the difficulties to perform radical resection for the patient.For patients with gastrointestinal cancer, radical surgery is the only chance to achieve complete cure.After 7 days, the patient recovered and was discharged from hospital, and the pathological results were also released, which satisfied us and our family members. The complete pathological remission was achieved, and no tumor cells could be found on the specimen, which meant that the patient would have a good recovery after treatment.(Postoperative pathological TRG grading 0 lymph nodes:0/67) Expert card Li Dan,Deputy chief physician of Gastrointestinal Surgery department of Henan Provincial People’s Hospital, Supervisor of postgraduate students, Vice chairman of Rectal cancer Anus preservation Training Base of Chinese Medical Education Association, Standing member of colorectal cancer Special Committee of Chinese Geriatric Health Care Society, Chairman of Henan Branch of Chinese Rectal Cancer Anus preservation Alliance, American Society of Gastrointestinal Endoscopic SurgeonsMember Standing Member, Cancer Prevention and Control, Health Management Society of Henan Province Standing Member, Retroperitoneal Tumor Professional Committee, Henan Anti-Cancer Association member of China NOSES AllianceStanding Member of Henan Branch, Member of The Professional Committee of Gastric Cancer of Henan Anti-Cancer Association, Member of the Professional Committee of Targeted Therapy of Henan Anti-Cancer Association, member of the Professional Committee of Palliative Therapy of Henan Anti-Cancer AssociationIn particular, he has rich clinical experience in the surgical and comprehensive treatment of gastric cancer, gastroesophageal junction cancer (cardia cancer), colorectal cancer, ultra-low rectal cancer, gastrointestinal stromal tumor, abdominal and pelvic tumors, metabolic weight loss, constipation, gastroesophageal reflux and other diseases.