This is a surgery to remove all or part of the stomach.
Gastrectomy is most often done to treat
stomach cancer
.
It is currently the only way to cure stomach cancer. The use of
chemotherapy
and
radiation
after surgery may help improve survival. Even if the cancer is too advanced to be cured, gastrectomy can help to prevent bleeding, obstruction, and pain.
In addition to treating stomach cancer, this surgery may also be done to treat:
Ulcer diseaseBleedingInflammationBenign tumors in the stomach
If you are planning to have gastrectomy, your doctor will review a list of possible complications, which may include:
Damage to nearby organsLeaking from the new connection between the stomach, intestine, and/or esophagusInfectionBleedingHernia formation at the incision siteBlood clotsReaction to anesthesia
Factors that may increase the risk of complications include:
ObesityAdvanced ageSmokingPoor nutritional statusRespiratory disease or cardiac diseaseBe sure to discuss these risks with your doctor before the procedure.
Your doctor may do the following:
Physical examBlood testsFecal occult blood test
(FOBT)—a test to check for blood in the stool
Endoscopy—a procedure that uses a scope with a camera on the end to examine the gastrointestinal systemUpper GI series
—a series of x-rays of the esophagus, stomach, and intestine during and after drinking a
barium solutionCT scan
—a type of x-ray that uses a computer to make pictures of structures inside the body
Leading up to your procedure:
Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure, like:
Anti-inflammatory drugs (eg,
aspirin
)
Blood thinners, like
clopidogrel
(Plavix) or
warfarin
(Coumadin)
Your doctor may recommend:
Eating a special dietTaking antibioticsShowering the night before your surgery using antibacterial soapArrange to have someone drive you to and from the hospital. Also, arrange for someone to help you at home.Eat a light meal the night before the surgery. Do not eat or drink anything after midnight.General anesthesia
will be used. It will block any pain and keep you asleep through the surgery. It is given through an IV in your hand or arm.
The doctor will make an incision in your abdomen. Next, she will use surgical instruments to remove all or part of your stomach. If only part of your stomach is removed, it is called partial gastrectomy. With this type of surgery, the doctor will connect the remaining part of your stomach to your esophagus and small intestine.
If this is done for ulcer disease, the nerves that control acid production may also be cut. If all of your stomach is removed, it is called total gastrectomy. The doctor will attempt to make a new “stomach” using your intestinal tissue. The end of your esophagus will be attached to your small intestine.
If you have stomach cancer, the doctor will likely remove and examine lymph nodes as well. This is because cancer can spread through your lymphatic system.
After the surgery is complete, the doctor will close the muscles and skin of the abdomen with stitches or staples. Lastly, she will apply a dressing.
You will have pain during recovery. Ask your doctor about medicine to help with the pain.
This surgery is done in a hospital setting. The usual length of stay is 6-12 days. Your doctor may choose to keep you longer if complications arise.
Your doctor will give you guidelines on:
When and what you can eatHow you need to restrict your activityAsk your doctor about when it is safe to shower, bathe, or soak in water.
During the first few days after surgery, you may be restricted from eating. As your stomach stretches during recovery, you will be able to eat more at a time.
If you had a total gastrectomy, you will need to eat smaller amounts of foods more often.
After surgery,
you may experience:
Frequent
heartburnAbdominal painVitamin deficiencies
To treat these symptoms, your doctor will:
Prescribe medicines and vitamin supplementsMake changes in your diet
Be sure to follow your doctor's
instructions
.
After you leave the hospital, contact your doctor if any of the following occurs:
Signs of infection, including fever and chillsRedness, swelling, increasing pain, excessive bleeding, or any discharge from the incision siteNausea and/or vomiting that you cannot control with the medicines you were given after surgery, or which persist for more than two days after discharge from the hospitalPain that you cannot control with the medicines you have been givenPain and/or swelling in your feet, calves, or legsPain, burning, urgency or frequency of urination, or persistent bleeding in the urineCough, shortness of breath, or chest painSwelling and/or pain in your legs, calves, or feet
In case of an emergency, call for medical help right away.
Last reviewed November 2012 by Daus Mahnke, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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