This rare surgery provides new hope for patients with aggressive cancers.
Mo Al Efishat, MD, FSSO, surgical oncologist at Our Lady of the Lake Cancer Institute, has performed the rare Appleby surgery to treat patients with gastric cancer. Dr. Al Efishat was able to remove all of the patient’s cancer with negative margins and the patient is doing well six months following the surgery.
The Appleby procedure, originally described to treat gastric cancer in the 1950s, is now more commonly used to treat advanced pancreatic cancer. It involves removing the affected area of the stomach with its major artery, the celiac trunk, while preserving the important blood flow to the liver.
Dr. Al Efishat’s patient originally had an unresectable gastroesophageal cancer that persisted following chemo and radiation therapy. The cancer was wrapped around the artery that supplies the stomach, liver and spleen. When evaluating treatment options, Dr. Al Efishat had the idea to revisit the Appleby procedure for its original purpose.
“This patient’s situation was complex, given how meticulous we had to be working around the blood vessels,” Dr. Al Efishat says. “Using the Appleby procedure allowed me to completely remove the patient’s cancer while still maintaining the blood supply to the vital organs.”
This is the first case using the surgical method at Our Lady of the Lake Regional Medical Center and in the region. By employing this procedure in the removal of pancreatic and gastric cancers, Our Lady of the Lake Cancer Institute can improve surgical outcomes and increase cure rates in high-risk and advanced tumors.
