Overview of Gastrectomy | Gastroenterology

Gastrectomy

What is gastrectomy?

A gastrectomy is a surgical procedure performed to remove all or part of the abdomen. The stomach is a J-shaped organ that processes nutrients and digestion. After eating, the food that is partially digested by the stomach passes into the intestines. There, it is being processed. This changes the way your body digests food by removing part or all of the stomach.

Purpose of gastrectomy

Gastrectomy is usually used to treat abdomen cancer, also known as gastric cancer.

Less often, it is used for treatment:

  • Life-threatening obesity
  • Oesophageal cancer
  • Stomach ulcers (open sores that receive on the inside lining of the stomach, also called peptic ulcers)
  • Non-cancerous tumors

Types of gastrectomy

There are many types of gastrectomy, including:

Partial gastrectomy: In this, a portion of the abdomen is excluded, leaving the lost area together. If the removal includes connections to the intestine or esophagus, the surgeon will need to reconnect these organs.

Total gastrectomy: It is the replacement of the entire abdomen through an incision made in the abdomen. Then the esophagus joins the small intestine.

Sleeve gastrectomy: This includes the removal of the left side of the abdomen. This is largely done to lose weight. The operation decreases the size of the stomach, making the person feel full after eating less.

Esaphagogastrectomy: The upper part of the stomach and part of the esophagus are removed.

Indications for gastrectomy

Total gastrectomy is indicated in the treatment of extensive abdominal malignancies. This radical procedure is not performed when there is Douglas carcinoma with distant metastasis to the liver or bursa or graft through the peritoneal cavity. This can be done in addition to the removal of adjacent organs, including the spleen, body, and tail, or part of the transverse colon. It is the preferred approach to control intractable ulcer diathesis associated with non-beta islet cell tumors of the pancreas when the pancreatic tumors or metastases are in a clinically uncontrollable state.

Risk factors for gastrectomy

The general risks factors for gastrectomy include:

  • Anesthesia effect, such as an allergic reaction and difficulties with breathing
  • Bleeding, which can begin to shock
  • A blood clot, inappropriate, a deep vein thrombosis that develops in the leg or pelvis
  • Infection

How it is performed?

There are two different ways to perform gastrectomy.

Open surgery: Open surgery includes a single large incision. Your surgeon excludes the skin, muscles, and tissues to enter your abdomen.

Laparoscopic surgery: Many small incisions (cuts) are made and laparoscopic surgical instruments are inserted into these small openings.

Procedure of gastrectomy

Before gastrectomy

Before undergoing a gastrectomy, patients need a variety of tests such as X-rays, computed tomography (CT), ultrasound, or endoscopic biopsies (microscopic examination of tissue) to confirm the diagnosis and locate the tumor or lesion. A laparoscopy may be performed to confirm malignancy or to determine the extent of the tumor that has already been diagnosed. When a tumor is strongly suspected, a laparoscopy is often performed before surgery to remove the tumor; This method avoids the need for the patient to receive anesthesia twice and sometimes completely eliminates the need for surgery if the tumor found at laparoscopy is deemed useless.

During gastrectomy

The procedure begins with general anesthesia, making sure that the patient is pain-free and unconscious during the surgery. When the patient is intoxicated, intubated, and on a ventilator, surgery can begin.

The procedure can be performed in two ways: the traditional method is the new minimally invasive version, in which a small incision is made, including a large incision in the abdomen, or an incision in the belly button, and the surgeon uses a small incision to view the incision on the monitor.

Once the instruments are in effect, the required section of the abdomen is cut and re-sewn. For the entire procedure, when the entire stomach is removed, the esophagus is connected to the duodenum. If a part of the abdomen is removed, the edges can be sewn back together, but smaller, the abdomen.

Once the surgeon has completed the procedure, the instruments are removed, the incisions are closed, and anesthesia is stopped to awaken the patient. Once the patient begins to wake up, the trachea can be removed to allow the patient to breathe on their own without a ventilator.

Complications

As with any approach, problems are likely to arise. There are complications associated with this procedure:

  • Pushing food from your abdomen to your small bowel too fast (dumping syndrome)
  • Acid reflux
  • Diarrhea
  • Chest infections, including bronchitis and pneumonia
  • Internal bleeding
  • Nausea and vomiting
  • Stomach acid flowing into your esophagus, creating scarring and narrowing (stricture)
  • Vitamin deficiencies
  • Unintended weight loss

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