Stomach surgery also known as Gastrectomy is a surgical procedure that involves the partial or complete removal of the stomach. It is commonly performed to treat stomach cancer, as well as certain benign conditions such as peptic ulcers. 


The following section does not pertain to surgery for obesity (Bariatric Surgery) which is its own field and performed by specialist Bariatric surgeons.  


Gastrectomy may be performed using open surgery or via laparoscopic/ robotic techniques. This procedure has significant implications for digestion and nutrition, so careful consideration and planning are essential. 


Types of Gastrectomy

The commonest types of gastrectomy are:

  1. Partial Gastrectomy: In a partial gastrectomy, only a portion of the stomach is removed, typically the part containing the tumour or affected tissue. The remaining portion of the stomach is then connected to the small intestine to maintain digestive function.
  2. Total Gastrectomy: In a total gastrectomy, the entire stomach is removed. The oesophagus is then connected directly to the small intestine, usually resulting in significant changes to digestive function and dietary habits.


Surgery for gastric cancer also has specific oncological considerations and involves removal of local lymph node tissue or regional organs for cancer clearance and staging.


Risks and Complications:

While gastrectomy is generally considered safe, it may be associated with certain risks and complications, including:

  1. Infection: There is a risk of infection at the surgical site or within the abdominal cavity.
  2. Bleeding: Bleeding from the surgical site or surrounding blood vessels may occur during or after surgery.
  3. Leakage: Leakage from surgical connections or anastomoses can lead to infection or other complications.
  4. Digestive Problems: Gastrectomy can affect digestion and nutrient absorption, leading to symptoms such as nausea, vomiting, diarrhoea, or malnutrition.
  5. Dumping Syndrome: Rapid emptying of food from the stomach into the small intestine, known as dumping syndrome, can cause symptoms such as nausea, weakness, sweating, and diarrhoea.
  6. Weight Loss: Significant weight loss is common after gastrectomy surgery, which may require nutritional support or dietary supplements to prevent malnutrition.


Recovery and Post-operative Care
After gastrectomy surgery, patients will typically spend several days in the hospital for monitoring and recovery. 


Recovery times vary depending on the type and extent of the surgery, as well as individual factors such as overall health and fitness. 


During the recovery period, patients may receive the following post-operative care:

  1. Pain Management: Pain medications may be prescribed to manage discomfort or pain after surgery.
  2. Dietary Changes: Patients will need to follow a modified diet after gastrectomy surgery, starting with clear liquids and gradually advancing to solid foods as tolerated. Dietary changes may include eating smaller, more frequent meals and avoiding certain foods that may be difficult to digest.
  3. Monitoring: Patients will be closely monitored for signs of complications such as infection, bleeding, or leakage from surgical sites.
  4. Physical Activity: Gradual resumption of physical activity, under the guidance of healthcare professionals, can help promote recovery and prevent complications such as blood clots and muscle weakness.


Follow-up Care
Follow-up care is essential for patients who have undergone gastrectomy surgery and may include:

  1. Regular Medical Check-ups: Patients will need to attend regular follow-up appointments with their healthcare team to monitor recovery, address any concerns or complications, and adjust treatment as needed.
  2. Nutritional Counseling: Nutritional counseling and support from dietitians or nutritionists can help patients adapt to dietary changes and prevent malnutrition or deficiencies. Patients without a stomach need long term vitamin supplementation.
  3. Screening for Recurrence: For patients treated for stomach cancer, regular screening tests such as imaging scans or endoscopy may be recommended to monitor for signs of cancer recurrence.
  4. Support Groups: Joining support groups or seeking counseling services can provide emotional support and practical advice for coping with the physical and emotional challenges of living with a changed digestive system.
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