In today’s medical advances, gastroscopy can detect gastric cancer in addition to removing it. Gastroscopic removal of gastric cancer requires active cooperation and preparation of the patient in addition to the skillfulness of the surgeon. In order to ensure a smooth gastroscopic treatment, patients need to make some necessary preparations before the procedure.
Provide a detailed medical history
Taking a medical history allows the physician to fully understand the patient’s health and medications and helps to develop and evaluate the entire treatment plan. Therefore, the patient must cooperate with the physician by providing the following.
- With some medications that have antithrombotic effects, the patient needs to be off the medication for a period of time before endoscopic treatment can be performed. For example, aspirin and clopidogrel (trade name Bolivar) generally need to be discontinued for at least 7 days, and herbal anticoagulants such as salvia and panax ginseng powder need to be discontinued for at least 3 days. Patients should inform their doctors in advance if they are taking any of these drugs.
- Patients with co-morbidities, such as cardiovascular disease or lung disease, that may affect the safety of anesthesia will generally require further evaluation or even targeted treatment until the disease is controlled. Therefore, the patient must also provide the physician with information about his or her other medical conditions.
- Patients may be allergic to certain medications (e.g., antibiotics, anesthetics), and it is important to inform the physician if they have experienced allergies.
Perfecting the test
In addition to the tests used to diagnose gastric cancer, there are several tests that patients need to undergo before surgery to assess their general condition and ensure a safe procedure.
- Blood workup. The main purpose is to see if the patient is in an acute phase of recent inflammation, which may be exacerbated by endoscopic treatment, and based on the results, the surgeon will decide if prophylactic anti-inflammatory therapy should be administered before or after the procedure. Also, since anesthesia is required to cooperate, the physician can assess whether the patient can tolerate the procedure and anesthesia by using some of the indicators in the routine blood test.
- Liver and kidney function and blood electrolytes are also used to determine whether the patient can tolerate the surgery and to predict postoperative recovery.
- Coagulation markers to determine the patient’s coagulation and to ensure that he or she will not have dangerous conditions such as bleeding during surgery.
- Infectious disease screening. To ensure that each patient is treated safely and effectively, physicians need to screen patients for infectious diseases such as hepatitis B virus, hepatitis C virus, syphilis, and HIV before surgery to avoid cross-infection.
- Anesthesia evaluation. The physician will perform an anesthetic evaluation to determine if the patient is safe to receive anesthesia based on the patient’s overall condition.
Preparation for medication
Because of the high amount of mucus and foam in the stomach, the physician will usually ask the patient to take simethicone oil or streptozotocin prior to gastroscopy to clear the mucus and foam from the stomach and provide a clear view for the endoscopic procedure.
Dietary control
Three days before the procedure, patients are advised to eat easily digestible foods, such as thin rice, noodles, and tofu. Fasting is required 6 to 8 hours before surgery, and water is prohibited 6 hours before surgery. If there is a voiding disorder such as gastric retention, the surgeon will usually perform adequate gastrointestinal decompression before surgery and place a gastric tube to drain the stomach contents to ensure a good surgical environment
Preoperative care
- Patients who do not know much about endoscopic surgery are prone to nervousness and fear. Therefore, depending on the patient’s psychological needs, knowledge level, and tolerance, the patient can be appropriately made aware of the condition, the procedure, and can also receive psychological counseling as appropriate. Family members can encourage and comfort the patient to eliminate the nervousness and fear.
- The patient must remove the removable denture in the mouth.
- Patients are usually given intramuscular scopolamine 30 minutes before surgery to reduce intraoperative gastrointestinal spasm.
These are the things that patients usually need to do with their surgeon and prepare for the gastroscopic resection of gastric cancer before surgery. Understanding and preparing for the surgery according to the doctor’s requirements is the first step to a successful surgery. (Contributed by Hongwan Wang, Department of Gastrointestinal Oncology, The First Hospital of China Medical University)