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VNA of Care New England

Gastrectomy

(Total Gastrectomy; Partial Gastrectomy; Subtotal Gastrectomy; Stomach Removal)

Definition

This is a surgery to remove all or part of the stomach.
Abdominal Organs, Anterior View
gastro intestinal stomach
Copyright © Nucleus Medical Media, Inc.

Reasons for Procedure

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 disease
  • Bleeding
  • Inflammation
  • Benign tumors in the stomach

Possible Complications

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
  • Damage to nearby organs
  • Leaking from the new connection between the stomach, intestine, and/or esophagus
  • Infection
  • Bleeding
  • Hernia formation at the incision site
  • Blood clots
  • Reaction to anesthesia
Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications, such as:

What to Expect

Prior to Procedure

Your doctor may do the following:
Leading up to your procedure:
  • Talk to your doctor about your medications. You may be asked to stop taking some medications up to one week before the procedure, like:
    • Anti-inflammatory drugs
    • Blood thinners
    • Antiplatelets
  • Your doctor may recommend:
    • Eating a special diet
    • Taking antibiotics
    • Showering the night before your surgery using antibacterial soap
  • Arrange 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.

Anesthesia

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.

Description of the Procedure

An incision will be made in your abdomen. Next, surgical instruments will be used 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 remaining part of your stomach will be connected 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. A new stomach will be made using your intestinal tissue. The end of your esophagus will be attached to your small intestine.
If you have stomach cancer, the lymph nodes will be removed and examined 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. A dressing will be applied.

How Long Will It Take?

1-3 hours or longer

How Much Will It Hurt?

Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.

Average Hospital Stay

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.

Post-procedure Care

At the Hospital
Your doctor will give you guidelines on:
  • When and what you can eat
  • How you need to restrict your activity
  • 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 heartburn
  • Abdominal pain
  • Vitamin deficiencies
To treat these symptoms, your doctor will:
  • Prescribe medications and vitamin supplements
  • Recommend medications to reduce stomach acid
  • Make changes in your diet
Preventing Infection
During your stay, the hospital staff will take steps to reduce your chance of infection, such as:
  • Washing their hands
  • Wearing gloves or masks
  • Keeping your incisions covered
There are also steps you can take to reduce your chance of infection, such as:
  • Washing your hands often and reminding visitors and healthcare providers to do the same
  • Reminding your healthcare providers to wear gloves or masks
  • Not allowing others to touch your incision

Call Your Doctor

Call your doctor if any of these occur:
  • Signs of infection, including fever and chills
  • Diarrhea
  • Redness, swelling, increasing pain, excessive bleeding, or any discharge from the incision site
  • Persistent nausea and/or vomiting
  • Pain that you cannot control with the medications you have been given
  • Pain and/or swelling in your feet, calves, or legs
  • Pain, burning, urgency or frequency of urination, or persistent bleeding in the urine
  • Cough, shortness of breath, or chest pain
  • Swelling and/or pain in your legs, calves, or feet
If you think you have an emergency, call for medical help right away.

RESOURCES

American Gastroenterological Association http://www.gastro.org

National Cancer Institute http://www.cancer.gov

CANADIAN RESOURCES

BC Cancer Agency http://www.bccancer.bc.ca

Canadian Cancer Society http://www.cancer.ca

References

Surgery for stomach cancer. American Cancer Society website. Available at: http://www.cancer.org/cancer/stomachcancer/detailedguide/stomach-cancer-treating-types-of-surgery. Updated February 22, 2013. Accessed December 6, 2013.

Surgery to remove stomach cancer. Cancer Research UK website. Available at: http://www.cancerhelp.org.uk/help/default.asp?page=3917. Updated June 14, 2012. Accessed December 6, 2013.

What you need to know about stomach cancer. National Cancer Institute website. Available at: http://www.cancer.gov/cancertopics/wyntk/stomach. Updated October 15, 2009. Accessed December 6, 2013.

Revision Information

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