What is Gastrointestinal Cancer Surgery?
Gastrointestinal (GI) cancer surgery involves the surgical removal of malignant tumors within the gastrointestinal tract, which includes the esophagus, stomach, liver, pancreas, gallbladder, small intestine, colon, rectum, and anus. The goal of surgery can be curative (to remove the cancer completely) or palliative (to relieve symptoms and improve quality of life).
When is GI Cancer Surgery Recommended?
GI cancer surgery is typically recommended when:
- The cancer is localized and can be removed completely (curative intent).
- There is a chance to prolong survival or achieve remission, especially in early to mid-stage cancers.
- Symptoms need relief, such as bleeding, obstruction, or pain (palliative intent).
- To obtain a biopsy or staging information when other methods are inconclusive.
It is usually part of a multidisciplinary treatment plan and may follow or precede chemotherapy or radiation, depending on the type and stage of cancer.
Types of Gastrointestinal Cancer Surgeries
Some of the types of GI cancer surgeries include:
- Esophagectomy (removal of part/all of the esophagus) for esophageal cancer
- Gastrectomy (partial or total stomach removal) for stomach cancer
- Colectomy (removal of part/all of the colon) for colon cancer
- Hepatectomy (removal of part of the liver) for liver cancer
- Cholecystectomy (removal of the gallbladder) for gallbladder cancer
- Pancreaticoduodenectomy (Whipple procedure) for pancreatic cancer
- Transanal excision (TAE) or low anterior resection (LAR) for rectal cancer
Procedure for Gastrointestinal Cancer Surgeries
The procedure for gastrointestinal cancer surgeries varies depending on the type and location of the cancer, but most follow a similar structured process.
- The patient is placed under general anesthesia to ensure they are unconscious and pain-free during surgery.
- The surgeon makes an incision in the abdomen or uses minimally invasive techniques (laparoscopic or robotic) to access the affected organ.
- The cancerous portion of the GI tract (e.g., part of the stomach, colon, liver, or pancreas) and surrounding margins (rim of healthy tissue) are also removed to ensure no cancer cells remain.
- Nearby lymph nodes are often removed and sent for pathology to check for cancer spread.
- The GI tract is reconnected (anastomosis) to restore continuity for digestion.
- In some cases, a stoma or artificial opening (e.g., colostomy or ileostomy) is created if reconnection is not possible immediately.
- The incision is closed using staples or sutures, and a sterile dressing is applied.
Postoperative Care
Postoperative care following GI cancer surgery focuses on recovery, preventing complications, and supporting the return of normal digestive function. Patients are closely monitored in the hospital for vital signs, pain management, and wound healing. Intravenous fluids and nutrition may be given initially, with a gradual return to oral intake as bowel function resumes. Pain is managed with medications, and early mobilization is encouraged to prevent blood clots and improve recovery. The care team monitors for signs of infection, bleeding, or leakage from surgical connections. Depending on the surgery, a temporary stoma may require special care. Follow-up includes pathology results, possible additional treatments like chemotherapy, and long-term dietary and lifestyle guidance.
Risks and Complications
Gastrointestinal (GI) cancer surgery carries risks and potential complications like any major operation. Common risks include:
- Bleeding
- Infection
- Anastomotic leak (leakage at the surgical connection site)
- Damage to nearby organs (e.g., liver, spleen, intestines)
- Blood clots (deep vein thrombosis or pulmonary embolism)
- Delayed bowel function (ileus)
- Wound complications (poor healing, hernia)
- Nutritional deficiencies
