OPERATION: Partial (Subtotal) Gastrectomy (Open) with D2 Lymphadenectomy
ANAESTHETIC: General anaesthesia with epidural
ANTIBIOTICS: IV antibiotics at induction
POSITION: Supine. Urinary catheter. Nasogastric tube.
INDICATION:
Gastric carcinoma of the distal stomach, amenable to curative resection. Preoperative staging: CT, EUS, OGD. No evidence of peritoneal deposits, N3/N4 nodal involvement, or unresectable local invasion confirmed on staging.
PROCEDURE:
WHO Checklist performed. Long midline incision. [Xiphoid process excised if required]. Full exploratory laparotomy performed — pelvis, para-aortic nodes, root of mesentery, small and large bowel, liver, diaphragm, gallbladder, and upper abdomen systematically assessed. [Peritoneal washings taken.] Resection confirmed appropriate.