Surgery can be used to treat various types of GI cancers, including: • Stomach cancer (gastric cancer) • Colon and rectal cancer (colorectal cancer) • Pancreatic cancer • Liver cancer (including liver resection or liver transplantation) • Esophageal cancer • Bile duct cancer • Small bowel cancer

The exact procedure will depend on the type of cancer, its location, and how far it has spread. Common types of GI cancer surgeries include: • Resection: Removal of the tumor and part of the affected organ. For example, a portion of the colon or stomach may be removed. • Whipple procedure: A surgery for pancreatic cancer, where the head of the pancreas, part of the small intestine, gallbladder, and bile duct are removed. • Esophagectomy: Removal of part or all of the esophagus in cases of esophageal cancer. • Liver resection: Removal of part of the liver affected by cancer. • Colectomy: Removal of part or all of the colon for colorectal cancer. The surgery is typically performed under general anesthesia, and the procedure may take several hours depending on its complexity.

Like any major surgery, gastrointestinal cancer surgery carries certain risks: • Infection at the surgical site • Bleeding during or after surgery • Damage to surrounding organs such as the liver, bowel, or nerves • Bowel obstruction or anastomotic leak (a leak where the organs are reconnected after resection) • Blood clots (deep vein thrombosis or pulmonary embolism) • Nutritional deficiencies due to changes in digestion or absorption after surgery • Delayed gastric emptying, especially if part of the stomach or intestines is removed

The length of your hospital stay will depend on the type of surgery and your recovery progress: • Stomach, colon, and rectal surgeries: Typically 5-7 days. • Pancreatic or liver surgeries: May require 7-10 days or more for recovery. • Complicated cases or additional treatments: Hospital stays may be longer, particularly if there are complications.

• Immediately after surgery: You will be monitored closely in the hospital for signs of infection, bleeding, or other complications. • Pain management: Pain medications will be prescribed, and your healthcare team will monitor your comfort level. • Diet changes: You may need to start with clear liquids or soft foods and gradually reintroduce regular foods as your digestive system heals. • Activity restrictions: Avoid heavy lifting or strenuous activities for 6-8 weeks while your body heals. • Follow-up care: You will need regular follow-up visits to monitor healing, nutritional intake, and any signs of cancer recurrence.

Some patients may need a feeding tube temporarily after surgery to ensure proper nutrition, especially if part of the digestive system is removed or altered. The tube may be used to deliver nutrients directly to the stomach or small intestine. Your healthcare team will evaluate your nutritional needs and help you through this process.

Recovery time depends on the extent of the surgery and your overall health: • Short-term recovery (1-2 months): Most patients can resume light activities within a few weeks. • Full recovery (3-6 months): Returning to a full, active lifestyle may take 3-6 months, especially if you need additional treatments like chemotherapy or radiation. • Long-term recovery: Some patients may experience ongoing challenges related to digestion, appetite, or weight management, depending on how much of the gastrointestinal tract was affected.

It is common for surgery to be followed by additional treatments such as chemotherapy, radiation therapy, or targeted therapies. These treatments are used to: • Kill remaining cancer cells that may not have been removed during surgery. • Reduce the risk of cancer recurrence. • Treat cancer that has spread beyond the area of the surgery. Your doctor will work with you to develop a treatment plan based on the stage of your cancer, the type of surgery, and your overall health.

Depending on the type of surgery you have, you may experience long-term changes in digestion: • Stomach surgeries: You may experience early satiety (feeling full quickly) or digestive difficulties, especially if part of the stomach is removed. • Colorectal surgery: You may experience changes in bowel movements, such as diarrhea or constipation, or need to adapt to life with a colostomy or ileostomy (a surgically created opening for waste removal). • Pancreatic surgery: If part of the pancreas is removed, you may need enzyme replacements to aid digestion and prevent malnutrition. In most cases, adjustments to diet and medications can help manage these changes.

To prepare for GI cancer surgery, your doctor may recommend: • Preoperative tests: Imaging scans, blood work, and possibly a biopsy to assess the extent of cancer. • Dietary changes: You may need to follow a special diet before surgery, including fasting for 12-24 hours prior to the procedure. • Stopping certain medications: If you’re taking medications like blood thinners, you may need to stop them before surgery. • Arranging for help: Surgery recovery may require assistance at home, so arrange for someone to help with daily tasks during your initial recovery period.

The outlook after gastrointestinal cancer surgery depends on several factors: • Stage of cancer: If the cancer is detected early and can be completely removed, the chances of recovery and survival are higher. • Cancer recurrence: Follow-up treatments like chemotherapy or radiation help reduce the risk of cancer coming back. • Overall health: Your age, fitness, and how well you respond to post-operative treatments play a role in long-term recovery. For many patients, surgery offers a good chance of recovery, especially if combined with other therapies.