J.Jpn. Surg. Soc.. 108(1): 10-14, 2007

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Feature topic

INFORMED CONSENT FOR GASTRIC CANCER SURGERY

Gastric cancer patients must have sufficient information on their prognosis and the risks and benefits associated with different therapeutic options before giving informed consent for treatment. The clinical stage of the cancer should be explained, along with the possibility of stage migration after surgery. The procedure proposed should be compared with other therapies including best supportive care, with explanations of postoperative prognosis, actual morbidity and mortality rates at the individual institution, and aftereffects. The surgeon should also explain measures to prevent and treat aftereffects, including dietary restrictions, reflux, dumping syndrome, and adhesive bowel obstruction. Because some patients refuse blood transfusions on religious grounds, the consent to undergo transfusion should be obtained separately from that to undergo surgery. Resected tissue is considered to be personal information, and consent must be obtained for its use in subsequent research after histopathologic examination. Adjuvant chemotherapy using S-1 is a standard treatment option in advanced gastric cancer of stage II or III, for which patients should make an informed choice after sufficient explanations of its efficacy and adverse effects.

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