I. Indications and Procedures
i. Adenocarcinoma—most frequent diagnosis
ii. Generally requires open technique and abdominal incision
iii. Laparoscopic gastrectomy may be performed in early
stage gastric cancers or when surgery is intended only for
palliation of pain and symptomatic relief rather than cure.
iv. Type of resection depends on whether the location of the
gastric erosion is proximal or distal.
i. Gastrectomy (usually partial) is performed for treatment
of severe peptic ulcer where disease does not respond
satisfactorily to medical therapy, for presence of bleeding
or perforated ulcer, or for pyloric obstruction.
ii. Antrectomy is usual procedure of choice for severe ulcer
iii. Antrectomy may be combined with other surgical
procedures, such as a vagotomy, in presence of duodenal
a. Morbidity: An estimated 21,500 Americans will be
diagnosed with gastric cancer in 2008, and two-thirds
are over the age of 66 (National Cancer Institute [NCI],
b. Mortality: Operative mortality rate in gastric cancer is as
low as 1% to 3% (Layke & Lopez, 2004).
The client is admitted to inpatient or same day outpatient
surgical unit. The procedure may be done as an open procedure
or via laparoscope.
Psychosocial aspects of care
Total nutritional support: parenteral/enteral feeding
Upper gastrointestinal/esophageal bleeding
1. Promote healing and adequate nutritional intake.
2. Prevent complications.
3. Provide information about surgical procedure, prognosis,
treatment needs, and concerns.
1. Nutritional intake adequate for individual needs.
2. Complications prevented or minimized.
3. Surgical procedure, prognosis, therapeutic regimen, and
long-term needs understood.
4. Plan in place to meet needs after discharge.