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Gastric cancer 

Gastric cancer
Chapter:
Gastric cancer
Author(s):

M. Asif Chaudry

, Sri G. Thrumurthy

, and Muntzer Mughal

DOI:
10.1093/med/9780199663200.003.0009
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date: 24 May 2018

This chapter begins by describing in detail the epidemiology and pathophysiology of gastric adenocarcinoma. Gastrointestinal stromal tumours and gastric lymphomas are then discussed in detail, including their clinical presentation, diagnosis and screening, and clinical evaluation. The principles of staging gastric cancer are then explored, followed by neoadjuvant therapy. The surgical management of gastric cancer is covered in great detail, including the types of gastrectomy, extent of lymphadenectomy, post-resection reconstruction, and duodenal bypass; as are the stepwise operative techniques for staging laparoscopy, D2 total gastrectomy, D2 subtotal gastrectomy, laparoscopic gastrectomy, laparoscopic versus open gastrectomy, and resection of gastric gastrointestinal stromal tumours. The complications of gastric surgery are then discussed, followed by follow-up and surveillance strategies. Adjuvant chemoradiotherapy and adjuvant chemotherapy are then discussed. The chapter also describes the various palliative strategies for inoperable or advanced gastric cancer, including self-expanding metal stents, endoscopic or radiological palliation, palliative chemotherapy, and surgical palliation.

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