The role of a general surgeon includes the removal of suspicious masses throughout the body. Patients may have had a radiographic study for other reasons such as after a trauma. If a mass is seen, it needs appropriate testing. This may include other radiographic studies, an upper endoscopy, lower endoscopy, or a needle directed biopsy. Despite testing, sometimes masses remain concerning by radiographic means without the ability to get an adequate tissue sample. If the mass is felt to have a high likelihood of being malignant, it is often removed as if it were a cancer. In other cases, the mass has been proven to be cancerous and deemed small enough to excise without undue risk to the patient. Prior to any surgical procedure patients should discuss their treatment options with an oncologist and a surgeon to decide on the appropriate treatment.
Masses of the stomach remain a challenging surgical problem. The first step in determining the treatment of a mass is a history and physical. Of particular concern in the history is the type of risk factors involved with the mass in question. The typical stomach cancer is associated with a well-known set of risk factors.
● Smoking: Smoking is a risk factor for a number of cancers, including stomach cancer. The chemicals in tobacco smoke and nicotine damage DNA and can lead to cancer. The best thing patients can do is to stop all tobacco use.
● Smoked Foods: Similar to smoking, smoked foods can also lead to the development of stomach cancer. Some cultures have diets that are high in smoked foods and the nitrosamines in these foods can also lead to stomach cancer.
● H. Pylori: This is a bacteria that causes stomach ulcers. If the bacteria remains untreated, it can continue to cause inflammation which can lead to cancer. Symptomatic patients are easily treated with antibiotics and anti-acid medications.
For small, localized masses without adequate pathology the most appropriate treatment is a wedge resection. The surgeon can use either an open or laparoscopic technique to isolate the mass. This is then stapled out and sent to pathology. The surgeon can simultaneously look for signs of metastasis and send any other concerning tissue to pathology. Depending on the diagnosis, patients may require another surgical procedure or alternatively, may benefit from chemotherapy, radiation, or other medical treatment. A wedge biopsy allows the surgeon to adequately diagnose and sometimes treat small gastric masses without undue risk of an extensive procedure so that patients may make informed treatment decisions.
Dr. Jenna Kazil is a first-class Bradenton based vascular surgeon who understands the complexity of gastric surgery and works hard to maximize the quality of life for her patients. Dr. Kazil is an acclaimed vascular and general surgeon in Manatee County who sees patients at the Florida Surgical Clinic and operates at various West Florida hospitals. Patients from the West coast of Florida from Tampa and St. Petersburg to Sarasota looking to find a world-class surgical specialist in general or vascular surgery to discuss treatment options should contact Florida Surgical Clinic to schedule an appointment with Dr. Kazil.