Gastrectomy

Gastrectomy is the surgical removal of part or all of the stomach. When gastrectomy is performed, gastric resection is required to reconnect the gastrointestinal tract so that digestion can take place as normally as possible.

Candidates for gastrectomy and gastric resection include those who have the following medical conditions:

  • Cancer of the stomach or esophagus
  • Severe gastric ulcers
  • Gastric bleeding
  • Inflammation of the stomach
  • Benign polyps or tumors

A person with life-threatening obesity that can only be corrected by gastric bypass is also a candidate.

Types of Gastrectomy

Depending on the reason for gastrectomy, more or less tissue may be removed. For example, in the case of stomach cancer, surrounding lymph nodes may be removed along with the tumor. Types of gastrectomy include total gastrectomy, partial gastrectomy, sleeve gastrectomy and esophagogastrectomy.

The Gastrectomy Procedure

Gastrectomy, particularly for the treatment of stomach cancer, is usually performed as open surgery, although, in some cases, the surgeon may opt to perform the surgery laparoscopically. Although the laparoscopic procedure involves a smaller incision, less scarring, and a shorter recovery time, open gastrectomy gives the surgeon a better view of the targeted area. Gastrectomy is performed under general anesthesia.

There is always a reconnection (gastric resection) included with gastrectomy so that digestion may proceed as normally as possible. In the case of a partial gastrectomy, the remaining portion of the stomach is reconnected to the small intestine. In a total gastrectomy, the intestine is reattached to the esophagus.

Risks of Gastrectomy

As with all surgeries, gastrectomy and gastric resection may have some of the following complications:

  • Excessive bleeding
  • Blood clots
  • Adverse reactions to anesthesia or medication
  • Postsurgical infection
  • Damage to adjacent organs
  • Breathing problems

Leakage from the connection to the intestine is also a risk, one that is specific to gastrectomy/gastric resection.

Recovery from Gastrectomy

Sometimes, a nasogastric tube is temporarily inserted through the nose and threaded into the stomach region after a gastrectomy to provide for drainage of intestinal fluid and gas, and to minimize nausea and vomiting. The necessity of using the nasogastric tube has, however, become controversial in recent years.

In the period immediately after surgery, the patient is fed intravenously. After about a week, the patient usually resumes a light diet, eating smaller meals than in the past but at more frequent intervals.

Gradually, over the course of a few months, the patient is able to resume eating a normal diet, and is comfortable ingesting a normal quantity of food at one sitting. The patient will, however, usually have to make some dietary changes, such as eating less fiber and taking certain vitamin and mineral supplements, after undergoing gastrectomy.

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