Delayed detection of stomach cancer, 25 lymph nodes had metastasized

Ms. Hue, 45 years old, has had indigestion for more than a year but has not gone to the doctor. Now the doctor discovered late stomach cancer with 25 metastatic lymph nodes.

Gastroscopy results at Tam Anh General Hospital in Ho Chi Minh City showed a 3 cm ulcer in the patient’s stomach area, the surface was rough, hard, and easily bled when touched. The patient also suffered from atrophic inflammation of the gastric mucosa. Computed tomography (CT) of the abdomen noted diffuse gastric wall thickening, loss of gastric layer structure, and surrounding fat infiltration. Biopsy results confirmed poorly differentiated adenocarcinoma (malignant disease).

On November 13, Dr. Do Minh Hung, Director of the Center for Gastrointestinal Endoscopy and Endoscopic Surgery, said the patient needed total gastrectomy and lymph node dissection. The surgical team noted that the tumor had spread near the cardia, performed a dissection of the greater omentum close to the transverse colon, cut arteries and veins, scraped out groups of lymph nodes, then cut across the duodenum, dissected lymph nodes and connected the esophagus to the jejunum. colon.

Post-operatively, Ms. Hue recovered well and was discharged from the hospital after 5 days. Pathology results were late stage 3B stomach cancer, cancer cells had invaded the outermost layer of the stomach, invaded lymph nodes and nerves, 25/32 lymph nodes had metastasized.

Ms. Hue said she was haunted by the painful endoscopy 10 years ago, so she had not had a medical screening in recent times. The doctor said that this was unfortunate because the cancer was discovered late, had metastasized to many lymph nodes, and had a very poor prognosis. “If you examine and detect the disease early when symptoms appear, the treatment effectiveness will be higher,” said Dr. Hung. In fact, today with modern techniques and machines, patients undergoing digestive endoscopy can be comfortable, pain-free, and discomfort-free.

 

Ms. Hue’s computed tomography scan showed a tumor in the stomach body (yellow arrow). Image: Tam Anh General Hospital

Gastrointestinal endoscopy is to insert an endoscope into the digestive tract to examine and accurately detect ulcers, cancer, polyps, HP bacteria… This method helps doctors screen for cancer early. digestive tract and can perform procedures such as polyp removal and early cancer lesion removal right during endoscopy.

During an endoscopy, a flexible tube passes through parts of the digestive tract, coming into direct contact with the patient’s secretions. Some microorganisms such as Helicobacter pylori, tuberculosis bacillus, blue pus bacillus, E.coli, typhoid, hepatitis A, B, C virus… can stick to the scope and cause disease if the scope is not secured. Disinfection meets standards, according to Dr. Hung.

To avoid infection, the endoscope handling process needs to ensure steps according to the standards of the Ministry of Health including on-site treatment, leak testing of the endoscope after each examination, mechanical and solution cleaning. disinfection. Instruments are placed into the automatic washing and disinfecting machine system for 20 minutes. After the machine has been safely sterilized, endoscopic instruments need to be stored in a cabinet with an automatic drying and sterilization system.

 

Modern scope washing and disinfecting machine system at Tam Anh General Hospital. Image: Hospital provided

Stomach cancer progresses silently, showing no early symptoms. Doctor Hung said the disease tends to increase and rejuvenate. If detected at an early stage, stomach cancer can be completely treated with gastric submucosal resection (ESD) through oral endoscopy or endoscopic surgery to remove the entire tumor without needing to remove the entire tumor. further treatment. In the late stage, cancer cells have progressed, lymph nodes have metastasized quite a lot, treatment is complicated and not very effective.

To prevent and detect the disease early, doctors recommend regular digestive examinations, especially as soon as suspicious symptoms appear. Currently, modern endoscopes and artificial intelligence (AI) applications can help doctors clearly observe small abnormalities.

By Editor

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