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Total Gastrectomy

The patient, Joseph, was experiencing severe swelling in his legs so went to see his GP for advice. Joseph’s GP noticed the severity of the condition and immediately referred him to Colchester NHS hospital where he was admitted for four days to undergo tests. After the tests were conducted, Joseph was referred back to his GP where he requested to be referred for treatment at London Bridge Hospital. Joseph’s referral decision followed his previous positive experience in 2009 when he underwent treatment at London Bridge Hospital for two heart.

Once admitted, the Consultant Cardiologist at London Bridge Hospital carried out a procedure that involved draining the fluid from Joseph’s legs and ran blood tests to determine the cause of the swelling. Joseph’s blood tests revealed a very low haemoglobin/ red blood cell count. The Consultant contacted the NHS Trust where Joseph had previously been treated and discovered that they were aware of the issue but had not recommended a treatment.

As part of the investigations for the low red cell count, Joseph underwent an endoscopy of the oesophagus and stomach in early August, under the care of Dr Jason Dunn Consultant Gastroenterologist. The endoscopy revealed an abnormal growth in the stomach. Biopsies of the growth were taken and confirmed the diagnosis of stomach cancer. Joseph was then referred to Dr Nicholas Maisey Consultant Oncologist at London Bridge Hospital for further tests. A Positron Emission Tomography (PET) scan demonstrated that Joseph had a very large, stomach tumour but thankfully there was no evidence of spread of the cancer to other parts of the body.

The results of all the investigations were discussed by the Upper Gastro-intestinal Multidisciplinary Team and it was agreed that the best course of action should be chemotherapy, which if effective would shrink the cancer and allow a successful operation under the care of Mr James Gossage Consultant General Surgeon.

Following 24 weeks of chemotherapy, overseen by Dr Maisey and delivered on the Oncology Unit at London Bridge Hospital, the repeat scans confirmed significant shrinkage of the cancer. Joseph was referred to Mr James Gossage, Consultant General Surgeon at London Bridge Hospital who performed a gastrectomy to remove the tumour. Because of the position of the tumour, Mr Gossage recommended a total gastrectomy, which would remove the entire stomach and the tumour.

The surgery took place in March 2014 and Joseph stayed in intensive care at London Bridge hospital for 5 days to monitor his kidneys and heart. He was initially fed intravenously and progressed onto liquid food following his surgery. He was discharged after 15 days managing a good diet.

During Joseph’s recovery blood tests showed that his kidney function had deteriorated significantly and he was urgently referred to Dr James Pattison, Consultant Nephrologist at London Bridge Hospital. Dr Pattison concluded that the extensive surgery and change in Joseph’s diet and fluid intake, had led to severe dehydration causing the kidney failure. Joseph was readmitted to London Bridge Hospital under the care of Dr Pattison. Following 10 days of support Joseph’s kidney function improved considerably.

Following his recovery and subsequent discharge, Joseph has recovered extremely well. Despite being predicted to make a full recovery within 6 months, within just a short few months Joseph is on the way to a healthy recovery. He comments that surgery has not limited the foods he can eat and can now eat anything he wants providing he eats smaller portions at more frequent intervals.

Joseph comments, “Mr Gossage did a wonderful job. The operation site healed very well and I’m eating more or less normally now two months later." Joseph continued by saying “recovery has been very good and the care that I received from London Bridge, Mr Gossage, Mr Maisey & Mr Pattison was absolutely brilliant”.

During his recovery he has spent time with his two children – a son aged 31 and a daughter aged 29 - and with his dog, whom he is back to walking everyday.

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