GI Onco Surgery

Gastrointestinal oncology surgery deals with cancers in the food pipe, stomach, liver, pancreas, large intestine, rectum, and anal canal butt. Treatment involves surgery chemotherapy, radiation, special treatments, and immune system boosters to treat cancer and allow patients to live a better life.

Significance of GI Oncology Surgery

GI oncology surgery plays an important role in:

• Tumour Resection: It involves surgically removing primary GI tumors and affected lymph nodes, aiming to fully excise the tumor, reduce local recurrence risk, and potentially cure early-stage cancers.
• Palliation: The surgery helps to relieve advanced or metastatic GI cancer symptoms. It can solve issues like obstruction, bleeding, and pain, improving quality of life.
• Multimodal Treatment: Combining surgery with chemotherapy, radiation therapy, and targeted therapies improves outcomes for locally advanced, recurrent, or metastatic GI cancers.

Types of GI Cancers and Surgical Procedures

• Esophageal Cancer (food pipe): It involves removing a part or all of the esophagus (esophagectomy) along with the lymph nodes (lymph node dissection). The gastrointestinal tract is reconstructed to restore continuity using stomach (esophagogastrostomy or esophagojejunostomy).
• Gastric (Stomach) Cancer: Part or all of the stomach is removed (partial or total gastrectomy) along with the regional lymph nodes (lymphadenectomy). Reconstruction techniques (gastrojejunostomy or gastrostomy) are often used.
• Liver Cancer: For primary liver tumors (hepatocellular carcinoma) or metastatic lesions from colorectal or other GI cancers, partial liver removal (hepatic resection), liver segmentectomy, or liver transplant may be done.
• Pancreatic Cancer: The Whipple procedure (pancreaticoduodenectomy) removes tumors in the pancreas head while distal pancreatectomy removes tumors in the body or tail. A total pancreatectomy is sometimes done, followed by pancreatic reconstruction, bile duct management, and digestive continuity restoration.
• Colorectal Cancer: It includes colectomy (partial or total colon removal) or proctectomy (rectal removal) with anastomosis or colostomy creation where lymph nodes are dissected. Adjuvant therapies may also be given.
• Anal Cancer: The surgical options treating anal cancer involve wide local excision, removing the anus and rectum (abdominoperineal resection), and sphincter preserving procedures. The choice depends on tumor location, cancer stage, and  patient factors.
• Gall Bladder cancer: Gall stones are highly prevalent in north India. incidence of gall bladder cancer is very high here. Complete resection offers permanent are in early stage.

Benefits

Surgery for GI cancers offers below advantages:

• Curative Intent: Complete removal of the tumor (negative margins/R0 resection) aims to cure early-stage localized GI cancers or control disease in the long term & surgery is the only option for most of G.I. cancer.
• Symptom Relief: Surgery eases symptoms like obstruction, bleeding, and pain, therefore enhancing the quality of life for advanced cases needing palliative care.
• Multidisciplinary Approach: Surgical oncologists collaborate with other departments, such as medical/radiation oncologists, gastroenterologists, radiologists, pathologists, and supportive teams, to ensure comprehensive personalized  treatment plans that optimize patient outcomes.