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The engineer needed to make a choice - choose a life without a stomach or die from stomach cancer.
Ghulam Abbas' last wish before the surgery, that would completely remove his stomach, was to gorge on a plate of chicken biryani.

Life was going on as usual until one day, the engineer needed to make a choice - choose a life without a stomach or die from stomach cancer.

After a long treatment to kill his cancer, he was advised that removing his stomach would be the best option. However, he had one wish before the surgery. "I asked the doctor if I could have chicken biryani as my last meal before the surgery. My wife prepared it and my brother carried it to the hospital. I sort of gorged on it," he said.

Abbas has two children, a one-and-a-half year old son and a six-year-old daughter. He was diagnosed with stage three cancer after he walked into Rashid Hospital's Gastroenterology clinic complaining of sudden weight loss and vomiting. Tests revealed that he had a huge tumour that covered almost his entire stomach.

"It's the most devastating decision and yet the answer was clear, I had to do whatever it look to save my life," he said.

"I did not want my children to grow up without my presence; I did not want to lose the opportunity to see their milestones, watch them laugh, even fight. I was not going to give up on my family and me. I just wanted to hold on to life," said Abbas.

"I had only one question. How would I be able to survive without a stomach?"

Gastric cancer is the second leading cause of cancer-related death and the fourth most common cancer worldwide.

Dr Ali Khammas, head of general surgery and consultant laparoscopic surgeon at Rashid Hospital, said: "In young patients unfortunately we see the cancer is very aggressive."

"There was no option but to conduct a total gastrectomy. We decided to perform the surgery minimally invasively, which has multiple advantages as opposed to open surgery. We have performed several colon cancer surgeries using this technique but for a total gastrectomy, it was the first-of-its-kind surgery in Dubai," added the doctor.

But before the surgery, doctors wanted to evaluate Abbas' response to chemotherapy.

Dr Omar Al Marzouqi, consultant laparoscopic surgeon, said: "Sometimes in aggressive cancers of this kind, the tumour increases in size and spreads rapidly even while the patient is on chemotherapy. We do not expose such patients to surgery. After two months of chemotherapy at Dubai Hospital, his tumour shrunk in size, so we decided to go ahead with the surgery," he said.

"After the chemotherapy I felt better. I was on nasal feed for two months and post the chemotherapy I actually ate four proper meals over the next few days. So I hoped that chemotherapy would be enough to tackle the tumour," said Abbas.

However doctors told Abbas that chemotherapy only shrinks the tumour but leaving a cancerous tumour inside the stomach is a ticking time bomb.

"I was relieved to know that it will be a minimally invasive surgery. It meant that I could have a quicker chance to recovery."

The next day Abbas went into a five-hour surgery. Dr Al Marzouqi, who performed the surgery with his team, said: "Traditionally such as surgery would involve opening up the abdomen vertically from the stomach to the pelvis but minimally invasive surgery is the way forward in many cases as it is less invasive and leads to much faster recovery time."

"For colon cancer cases we have used this method several times but this type of surgery was the first in Dubai. We laparoscopically removed the total stomach and the lymphatic drainage system from the root. We then reconstructed the whole area in such a way that the small bowel (small intestine) functions as the stomach."

The surgery was a success; the pathology report showed that the surrounding area was also free of cancer-cells.

Abbas is still undergoing chemotherapy at Dubai Hospital as a preventive measure.

Dr Al Marzouqi said: "It is normal to question how a person can live without a stomach. However, the body is able to bypass the stomach's main function of storing and breaking down food to gradually pass to the intestines. Without a stomach, food consumed in small quantities can move directly from the oesophagus to the small intestine."

Abbas needs to be very mindful of the quantities he consumes. He has to nourish his body in tiny meals throughout the day.

"Here the credit goes to my wife. She meticulously prepares small meals for me and I keep track of how often I need to eat. Post the surgery I was on watery liquids and then I moved on to thick liquids. I will soon start consuming small non-spicy meals.

"I've adapted to this new pattern. Things could have been worse. I'm here, alive, what more could I possibly ask for?"
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