Contents
In line with its mission, the Editorial Board of MedTvoiLokony makes every effort to provide reliable medical content supported by the latest scientific knowledge. The additional flag “Checked Content” indicates that the article has been reviewed by or written directly by a physician. This two-step verification: a medical journalist and a doctor allows us to provide the highest quality content in line with current medical knowledge.
Our commitment in this area has been appreciated, among others, by by the Association of Journalists for Health, which awarded the Editorial Board of MedTvoiLokony with the honorary title of the Great Educator.
Stomach resection (gastrectomy) is a surgical removal of this organ, which is performed as a result of certain diseases and very high obesity. The operation can be performed according to two methods: total or partial gastric resection, which is also called cuff resection. The stomach is a very important internal organ of a human being, while life without it is possible. However, this has considerable consequences and requires the implementation of a therapeutic diet that will ensure quick convalescence.
Stomach resection – methods
The operation is performed under general anesthesia (anesthesia). After opening the abdominal cavity, the surgeon assesses the organs and makes a decision on the choice of the method. Most often there is a need partial resectionwhich consists in removing lesions and a fragment of the stomach. In the case of neoplastic disease, a common procedure is a complete gastrectomy and – in the case of a malignant tumor – the lymph nodes, the greater net and also the spleen. There are two methods by which it is performed gastric resection:
- Total gastrectomy – it is a highly complicated operation performed using the Roux-en-Y method. The procedure, also known as a gastric bypass, involves suturing the esophagus with the small intestine. The intestine is then connected to the section of the intestine that carries bile and pancreatic juice from the duodenum. The anastomosis of the esophagus with the intestine and the anastomosis of the intestines can be performed with a standard surgical suture or with a mechanical suture, i.e. stapler.
- Sleeve (cuff) gastrectomy – the procedure involves the excision of about 70-85% of the stomach. Thus, its volume is significantly reduced. After the procedure, the stomach takes the shape of a tube or a sleeve, approximately 150 ml in volume. The operation can be performed in a classic way, i.e. by opening the abdominal wall or using the laparoscopic method. In the second case, a smaller amount of tissues is disturbed, thanks to which the convalescence after the procedure is much shorter.
Stomach resection – indications for surgery
- The first and most common indication of qualifying a patient for gastric resection is neoplastic disease. Stomach cancer is most often diagnosed in an advanced stage because of its symptoms. For this reason, the chances of successful treatment drop significantly and you need to act very quickly, most often by completely resecting the stomach together with the lymph nodes. The most common subtype of gastric cancer is adenocarcinoma. They constitute approximately 90% of all malignant gastric tumors in humans. Other subtypes of cancer that occur are lymphomas, sarcomas, carcinoids, and stromal tumors. Surgical methods, i.e. complete or partial resection, are the most commonly used methods to treat stomach cancer. In addition to this method, chemotherapy is also used.
- Currently, gastric resection in the case of peptic ulcer disease is used less and less. It is largely influenced by the development of various pharmacological agents and the awareness of the society. Sometimes gastric resection is necessary, if pharmacological treatment is not effective, if the bleeding from gastric ulcers is very heavy, or the pylorus of the stomach is narrowed. However, also in such cases removal of the stomach is not always necessary. In some situations, an alternative method is vagotomy. It involves cutting the fibers of the vagus nerve, which is responsible for sending a signal to the secretion of gastric juice.
- The last indication for partial gastrectomy is grade III obesity. It is also known as a last resort. Bariatric surgery is only performed on people who have a BMI greater than 40 and have tried to reduce weight before.
Diet after gastrectomy
Po total or partial gastric resection the patient must be ready for some changes in his daily life and austerities. This applies primarily to diet. After gastric resection it must be strictly adhered to and well fitted. After total gastrectomy the diet should consist of small and regularly consumed portions. Resection causes a significant reduction in the volume of the initial section of the digestive system. For this reason, food should not be gathered there. Diet it should be rich in large amounts of very lean meat, fish, eggs, dairy products, vegetable fats and fruit. Vegetables are also needed, but some caution is advised in these cases due to their fiber content. On the other hand, with diet legumes, cabbage, hot spices, coffee, black tea and alcohol should be completely removed.
Complications after gastrectomy
Stomach resection is a highly invasive procedure, therefore some may occur complications. The most common complicationswhich may occur after surgery are: bleeding, infection, hernia in the postoperative scar, leakage at the junction of the esophagus with the intestine, dehiscence of the postoperative wound with the expulsion of the intestines outside the abdominal cavity, nutrient and vitamin deficiency.