Radical Gastrectomy Surgery Abroad

Gastrectomy is a surgical procedure which involves the removal of the entire stomach or parts of the stomach. Stomach is an integral part of our gastro-intestinal system with a primary function of breaking down the food into its components so that they can be subsequently absorbed by the small intestine. Radical Gastrectomy refers to the partial or complete removal of the gastric tissue along with the surrounding lymph nodes. This is often the only available curative treatment option in cases of stomach (gastric) cancers. Radical Gastrectomy is a major surgical procedure and this surgery is available abroad, in India, Mexico, Turkey, Jordan & South Korea, at lower rates and keeping in mind international quality.

Why is Gastrectomy needed?

• The most common consideration for conducting a gastrectomy is gastric cancer. Gastric adenocarcinomas, primary gastric lymphomas (originating in the stomach), and the rare gastric sarcomas are managed well by gastrectomy.
• Occasionally, gastrectomy is recommended as a part of weight loss, especially among morbidly obese individuals. However this kind of gastrectomy does not require the removal of surrounding lymph nodes, which is absolutely essential in case of gastric cancers.
• Gastrectomy is also recommended in cases of peptic ulcers to avoid severe complications like gastric perforation, ascitics and obstruction of the pyloric canal (i.e. the blocking of the exit of the stomach). This kind of gastrectomy may or may not require the removal of surrounding lymph nodes.

Different radical gastrectomy procedures:

• Total gastrectomy: This procedure involves the complete removal of the stomach, and is especially, used for stomach cancer located in the middle of the stomach (which is not easily accessible). There are different ways of doing the surgery which include laparoscopic surgery and keyhole surgery (both the surgeries are done through a small incision on the abdomen), and the conventional method (where the patient is left open with a long scar which runs over the length of the abdomen).
• Subtotal gastrectomy: Similar to the total gastrectomy procedure, this procedure involves removal of only a part of the stomach, where the cancer is located. Even this procedure can be performed using a laparoscope or by the conventional surgical procedure.
• Sleeve and Mini Sleeve Gastrectomy: These procedures involve the removal of the stomach with the principal intent of management of morbidly obese patients and help them in weight loss. These methods are rarely used for cancer management.

Success and Survival Rates:

Clinical evidence suggests that five year survival rate after radical gastrectomy, for patient with gastric carcinomas detected in the early stage is about 80% to 90%. However for late stages of the disease the prognosis is fairly poor and ranges from 30% to 40%. The main cause of death in this situation is attributed to recurrence due to metastasis in 50% of the cases.

Preparing for Radical Gastrectomy:

• Prior to undertaking the surgery, the patient is made to go through a series of imaging and diagnostic tests like X ray, Ultrasonography, Endoscopy or CT scan to assess the location and expanse of the tumor.
• Laparoscopy may be required to review the extent of the tumor or to confirm the diagnosis. Often the laparoscopy is done just prior to the surgery to avoid sedating the patient twice.

Radical Gastrectomy Procedure:

The procedure is done under general anesthesia. Prior to undertaking the procedure, the following protocols are followed:

• A urinary catheter is introduced. This is essential to monitor the urine output especially in major surgical procedures like this one.
• A nasogastric tube is inserted from the nose to the stomach. This is to drain out the acidic gastric content and cleanse the stomach with antiseptic solution.

Most often conventional technique of radical gastrectomy is used, whereby a part or whole of the stomach is removed. The remaining part of the stomach is then connected to the small intestine so as to keep the gastrointestinal tract patent and allow passage of food material.

Laparoscopic gastrectomy has several advantages over the conventional procedure, namely:

• Reduction in post operative pain: This is largely attributed to the size of the abdominal incision which is much smaller in case of laparoscopic surgery.
• Reduced hospitalization: Healing of the wound is faster allowing the patient to return home at the earliest.
• Lesser recovery time: The procedure allows patient to recover quickly and return to his normal day to day activities sooner than the conventional procedure.

However laparoscopic gastrectomy has a limited role in the management of gastric carcinomas. It can be used only for early stage gastric carcinoma and in cases where the intention is to palliate and alleviate pain rather than cure.

Post operative care after of Radical Gastrectomy:

• Recovery can take as much as 3-4 weeks after the procedure. In the meantime the patient is required to follow strict medical protocol to avoid infections and minimize risks of complications.
• The patient is advised to adjust the dietary patterns like eating small quantities of food, having frequent meals and reducing the intake of liquids.
• In order to avoid reactive hypoglycemia, patients are suggested to have a diet which is rich in proteins.
• Vitamins, Folic Acid, Calcium and Iron supplements are recommended after radical gastrectomy. This is to correct certain deficiencies that would inevitably arise due to the surgery.

Radical Gastrectomy in India

The Indian advantage includes low cost (one tenth of the prices in US), international quality with advanced technology, wide ranging and comprehensive specialized oncology services and one of the largest English speaking population in the world.

Radical Gastrectomy in Mexico:

There are several centers and hospitals that have the JCI accreditation in the country which is the highlight of medical tourism. Its proximity to the United States gives it the added advantage over other destinations of medical tourism.

Radical Gastrectomy in Turkey:

Spanning across both Europe and the Near East, Turkey has impacted the global medical tourism market considerably. It provides considerable cost advantage and with its future plans of joining the European Union, the government and local administration have enforced stringent and rigid quality norms making is the first grade medical tourism destination.

Radical Gastrectomy in Jordan:

Jordan is focusing in a big way on medical tourism, which is estimated to be a $1 billion industry by 2010. With its focus on emerging as one of the hot spots for medical tourism in the Middle East, Jordan provides substantial advantage in terms of competitive cost and technology.

Radical Gastrectomy in South Korea:

In 2008, South Korea received around 25,000 foreign medical tourists, which was a rise of more than 50% compared to the previous year. The country has specifically focused on the treatment and management of various kinds of cancers of the stomach and liver. This has given it an added advantage over other countries in management of malignancies and cancers.

Resources:

Cyberknife in India
Cyberknife at Anadolu Medical Center, Turkey
Chemotherapy Treatment (CHOP) Abroad
RCHOP Chemotherapy
Cyberknife Cancer Radiotherapy Overseas

Medical Tourism Corporation facilitates affordable Radical Gastrectomy Abroad in Europe (Turkey) and other overseas world-class oncology treatment destinations.