x Abu Dhabi, UAEMonday 22 January 2018

Landmark surgery in stomach cancer case

The stomach was removed from a 28-year-old woman following the discovery of a large tumour. She is the youngest to have this procedure in the UAE.

ABU DHABI // A 28-year-old cancer patient has had her whole stomach surgically removed in what is believed to be the first operation of its kind in the UAE.

The woman of Arab descent had been suffering from abdominal pains for more than a year, and had no idea of the cause.

"She had been to see so many doctors, but no one knew the cause. Finally she was referred to me, and we did an investigative endoscopy to see what the problem was," said Dr Safwan Taha, medical director of Al Noor Hospital in Abu Dhabi.

In a career that spans more than 25 years and 120 cases of advanced stomach cancer, it was only the second time Dr Taha had encountered a patient under the age of 30 with a Stage Four tumour requiring the removal of the entire stomach. The other was in his native Iraq.

When the most recent patient came to his office about six weeks ago, a carcinoma, which Dr Taha described as the most aggressive type of malignant tumour, was found covering most of the patient's stomach.

"It was so big, and could be seen so clearly. The patient is just too young for this type of a disease and for a tumour this advanced. It is very, very rare for this to happen," he said.

There was no specific cause for this type of tumour, said Dr Taha, who is a consultant surgeon and the director of the laparoscopy and obesity surgery centre at the hospital.

Explanations could be as varied as genetic history or environmental factors. "It is rare for those under 30, but could happen to anyone," he said.

The only way to treat the patient was to remove her entire stomach. "The tumour involved almost three-quarters of the stomach, and as a safety margin we usually cut five centimetres around the edge of the tumour, which meant the entire stomach had to go," he said.

As frightening as that might sound, and as rare as it might be, it is standard procedure in such cases, he said.

It was the first time Dr Taha had performed the surgery in the UAE, although he had treated three older patients who required the same procedure. "They chose to go abroad, not ready to believe that we can do this here," he said.

Dr Taha's current patient, however, underwent the surgery with confidence and today is doing "extremely well and undergoing chemotherapy at Tawam Hospital", he said. "She made an excellent recovery, she has adapted very well and the procedure was a success."

To make up for the lack of a stomach, a part of her small intestine was brought up 30cm closer to her chest from her abdomen, and attached to her oesophagus.

"I then close the other end of the stomach, where the food used to go for digestion, and I create a passage with another part of the intestine for the bile and digestive secretions to empty through," Dr Taha said.

The patient has adapted 100 per cent to the change in her digestive tract, and will not face any eating difficulties or nutritional deficiencies, he said. "It is really a beautiful solution to a horrible disease."