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Continuing Education in Anaesthesia, Critical Care & Pain Advance Access originally published online on March 4, 2009
Continuing Education in Anaesthesia, Critical Care & Pain 2009 9(2):65-69; doi:10.1093/bjaceaccp/mkp007
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© The Author [2009]. Published by Oxford University Press on behalf of The Board of Directors of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournal.org

Gastrectomy for adenocarcinoma

Louise Powell, MB ChB FRCA
SPR Anaesthetics
Sheffield Teaching Hospitals NHS Trust
Royal Hallamshire Hospital
Glossop Road
Sheffield S10 2JF
UK

Gill Hood, FRCA
Consultant Anaesthetist
Sheffield Teaching Hospitals NHS Trust
Northern General Hospital
Herries Road
Sheffield S5 7AU
UK

Andrew Wyman, MD FRCS
Consultant Surgeon
Sheffield Teaching Hospitals NHS Trust
Royal Hallamshire Hospital
Glossop Road
Sheffield S10 2JF
UK
Tel: +44 (0)114 2434343 Fax: +44 (0)114 2268736 E-mail: gillian.hood@sth.nhs.uk

The first 150 words of the full text of this article appear below.


Key points

The overall incidence of gastric carcinoma has decreased over the past two decades. There are fewer distal gastric adenocarcinomas but more proximal carcinomas affecting the gastro-oesophageal junction.
Accurate staging is essential to determine the most appropriate therapeutic management.
Anaesthetic technique includes an epidural and general anaesthesia, with a potential for invasive monitoring and postoperative high dependency care depending on co-morbidity and type of surgery.
Perioperative chemotherapy improves long-term survival, but potential adverse effects must be sought before gastrectomy.

 

Over the last two decades, there has been a gradual decline in the number of patients presenting with gastric adenocarcinoma. In 2005, the overall incidence was 9.4 cases per 100 000 population within the UK and 6.4 per 100 000 within Europe;1,2 its incidence in men is twice of that of women. In the UK, there are about 8200 new cases each year and 6000 deaths.2 The decrease in incidence . . . [Full Text of this Article]


   Anatomy and physiology
 

   Risk factors
 

   Presentation and diagnosis
 

   Staging
 

   Management options
 
Adjuvant chemotherapy

Surgery

Lymphadenectomy

Specialist oesophago-gastric cancer teams


   Anaesthetic management
 
Preoperative assessment

History and examination

Investigations

Preoperative preparation

Intraoperative management

Postoperative nutritional management


   Complications
 

   Prognosis
 

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