A gastrectomy is the surgical removal of part or all of the stomach. When part or all of the stomach is removed, a gastric resection is necessary to reconnect the gastrointestinal tract so that digestion may continue to occur as normally as possible.
Candidates for a Gastrectomy
Candidates for a gastrectomy and gastric resection may include patients with the following medical conditions:
- Cancer of the stomach or esophagus
- Severe gastric ulcers
- Gastric bleeding
- Inflammation of the stomach
- Life-threatening obesity necessitating gastric bypass
- Non-malignant polyps or tumors
Types of Gastrectomy
Depending on the reasons for a gastrectomy, more or less tissue may be extracted. In the case of stomach cancer, surrounding lymph nodes as well as the tumor may be removed. Types of gastrectomy include:
- Total gastrectomy
- Partial gastrectomy
- Sleeve gastrectomy
The Gastrectomy Procedure
Gastrectomy, particularly for the treatment of stomach cancer, is most commonly performed as an open surgery, though in some cases the surgeon may opt to perform the surgery laparoscopically. While the laparoscopic procedure involves a smaller incision, less scarring, and a shorter recovery time, open gastrectomy provides the surgeon with a better visualization of the targeted area. Gastrectomy is performed under general anesthesia.
There is always a reconnection, or gastric resection, included in the gastrectomy procedure 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 a Gastrectomy
There are risks associated with any type of surgery. Though unlikely, a gastrectomy and gastric resection may have some of the following complications:
- Excessive bleeding
- Blood clots
- Adverse reactions to anesthesia or medications
- Post-surgical infection
- Damage to adjacent organs
- Breathing problems
- Leakage from the connection to the intestine
Recovery from a 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 can usually resume a light diet, eating smaller meals than usual at more frequent intervals.
Gradually, over the course of a few months, the patient will be able to resume eating a normal diet and will be comfortable ingesting a normal quantity of food at a sitting. The patient will, however, usually have to make some dietary changes after undergoing a gastrectomy, such as less fiber and the inclusion of certain vitamin and mineral supplements.