A gastrectomy is a surgical procedure done to remove all or part of the stomach.
When a gastrectomy is needed
A gastrectomy is usually used to treat stomach cancer. It's also used to treat:
- Life-threatening obesity
- Oesophageal cancer
- Stomach ulcers (peptic ulcers)
- Non-cancerous tumours
Gastrectomy is normally an effective treatment for cancer and obesity.
How a gastrectomy is performed
There are four major types of gastrectomy, depending on which part of your stomach needs to be removed:
- Total gastrectomy – the entire stomach is taken out.
- Partial gastrectomy – the lower part of the stomach is taken out.
- Sleeve gastrectomy – the left side of the stomach is taken out.
- Oesophago gastrectomy – the top part of the stomach and part of the oesophagus(gullet) is removed.
The top of the stomach is connected to the gullet, the bottom of the stomach to the first part of the small intestine, and the gullet to either the small intestine or the remaining part of the stomach. This means you will still have a working digestive system, even though it won't function as well as it did before. All types of gastrectomy are done under general anaesthetic, so you'll be asleep during the surgery.
Techniques for gastrectomy
Two different methods can be used to carry out a gastrectomy:
- Open gastrectomy – where a large incision is made in your stomach or chest.
- Keyhole surgery (laparoscopic gastrectomy) – where several smaller incisions are made and special surgical tools are used.
People who have keyhole surgery normally recuperate faster and have less pain after the surgical procedure than those who have an open gastrectomy. You may also be able to leave the hospital a little sooner.
Complication after keyhole surgery are similar to that of open gastrectomies. Open gastrectomies are normally more effective in treating advanced stomach cancer than keyhole surgery is. This is because it's normally easier to remove affected lymph nodes during an open gastrectomy.
Before you decide which surgical procedure to have, discuss the advantages and disadvantages of both with your doctor.
Recovering after a gastrectomy
A gastrectomy is a major surgical operation, so recovery can take a long time. You'll normally stay in hospital for one or two weeks after the surgery, where you may receive nutrition directly into a vein until you can eat and drink again.
Eventually, you’ll be able to digest most foods and liquids. However, you may need to make changes to your diet, such as eating regular small meals instead of three large meals every day. You may also need vitamin supplements to make sure you're getting the right nutrition.
Complications of gastrectomy
As with any type of surgical operation, a gastrectomy comes with a risk of complications, like infection, bleeding and leaking from the area that's been stitched together.
A gastrectomy may also lead to issues caused by a reduction in your ability to absorb vitamins, like anaemia or osteoporosis.
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