Gastrectomy: Causes, Symptoms, Treatment and Cost

A gastrectomy is a surgical treatment that involves the removal of all or a portion of the stomach. Gastrectomy may be performed using either an open surgery approach or laparoscopic (minimally invasive) approach. This procedure is usually done to treat stomach cancer, but can also be done for other conditions such as severe stomach ulcers or severe obesity.

Gastrectomy may be performed in a few different ways, including:

• Total Gastrectomy: A total gastrectomy involves removing the entire stomach, including all its tissue and organs. This type of surgery is typically used to treat advanced stages of gastric cancer, or when other treatments have failed.
• Subtotal Gastrectomy: A subtotal gastrectomy removes part of the stomach, leaving enough intact to allow for normal digestion and absorption of nutrients from food. This type of surgery may be used if a patient has early-stage gastric cancer or an ulcer that has not responded to other treatments.
• Proximal Gastrectomy: A proximal gastrectomy removes only the upper portion of the stomach, leaving behind enough tissue for normal digestion and absorption functions. This type of surgery may be used if a patient has early-stage cancer in this area or an ulcer that has not responded to other treatments.
• Distal Gastrectomy: A distal gastrectomy removes only the lower portion of the stomach, leaving behind enough tissue for normal digestion and absorption functions. This type of surgery may be used if a patient has early-stage cancer in this area or an ulcer that has not responded to other treatments.
• Laparoscopic Gastrectomy: Laparoscopic gastrectomies involve making small incisions in order to perform the procedure using specialized tools inserted through these incisions rather than open abdominal surgery with larger incisions made into abdominal wall muscles.

Gastrectomy can provide a number of benefits for those who undergo it:

• Reduced risk of cancer: By removing all or part of the stomach, gastrectomy reduces the risk of developing certain types of cancer in that area.
• Improved digestion: Gastrectomy can help improve digestion by allowing food to move more quickly through the digestive tract and reducing the amount of time it takes for food to be digested and absorbed into the body.
• Weight loss: By decreasing the quantity of food that may be consumed at one time and enhancing feelings of satisfaction after eating lesser quantities, a gastrectomy can aid in weight reduction.
• Improved quality of life: Gastrectomy can improve quality of life by reducing symptoms associated with certain conditions such as severe ulcers or gastroparesis (delayed emptying of stomach contents).

Gastrectomy is done to treat stomach cancer, but it can also be used to treat other conditions such as severe ulcers, gastric polyps, and some types of gastroparesis.

Gastrectomy can also be used as a weight loss surgery. The surgery entails removing a portion of the stomach and attaching the remaining portions straight to the small intestine. This limits food intake and reduces calorie absorption, leading to weight loss.

The most common risks of gastrectomy include:

• Bleeding: During the surgery, there is a risk of significant bleeding from the stomach, which can lead to shock or death.
• Infection: Any type of surgery carries a risk of infection, which can be serious and require antibiotics or additional surgery to treat it.
• Leakage: After the surgery, there is a risk of leakage from the staple line or suture line that was used to close the stomach incision. This can cause an abdominal infection and require additional treatment.
• Nutrition Deficiencies: Gastrectomy may cause deficiencies in certain vitamins and minerals due to reduced absorption in the stomach and intestines after the procedure. Patients may need to take supplements or adjust their diet accordingly to prevent deficiencies from occurring.
• Bowel Obstruction: After gastrectomy, there is an increased risk for bowel obstruction due to scar tissue formation at the site of the surgery or adhesions that form between organs in the abdomen after healing has occurred.
• Gastrointestinal Symptoms: Patients may experience nausea, vomiting, diarrhea, bloating, and other gastrointestinal symptoms after gastrectomy due to changes in how food moves through their digestive system following surgery.

Preparing for this procedure requires both physical and emotional preparation.

• Talk to Your Doctor: Make sure you understand all aspects of the procedure and ask any questions you may have before your surgery.
• Get Physically Ready: Follow any pre-operative instructions from your doctor, such as diet restrictions or other lifestyle changes that may be necessary prior to surgery.
• Prepare Emotionally: Take some time to prepare mentally and emotionally for the upcoming procedure and recovery process by talking with family members or friends about your concerns and fears.
• Arrange Transportation: If you are having a general anesthetic, arrange transportation home from the hospital after your surgery so that you can rest safely in a familiar environment with support from loved ones.
• Stock Up on Supplies: Make sure you have enough supplies at home such as gauze pads, bandages, pain relievers, vitamins, and supplements so that you can easily manage any post-operative needs without having to go out shopping for them in person after your procedure.

• In the course of the operation, the surgeon will create an incision in the patient's abdomen and remove a part of the patient's stomach.
• After that, the section of the stomach that has not yet been removed will be reattached to the small intestine.
• Depending on the type of gastrectomy that is performed, additional organs such as lymph nodes may also be removed.
• After surgery, patients will need to follow a special diet and take medications to help reduce their risk for complications.

• Get the patient's signed, informed consent.
• Perform a complete physical examination, including blood work and imaging scans to determine the severity of the condition and any probable side effects.
• Discuss the surgery, dangers, and expected recovery time with the patient.
• Provide preoperative instructions to the patient regarding diet, medications, and activity level prior to surgery.
• Prepare operating room equipment and supplies necessary for gastrectomy procedure.
• Ensure that anesthesia is ready for use during surgery as needed by the surgeon or anesthesiologist
• Administer preoperative medications according to physician orders
• Place intravenous (IV) lines for fluid administration and medication delivery during surgery

• Make an incision in the abdomen and locate the stomach.
• Separate the stomach from the oesophagus and the small intestine.
• Depending on the kind of gastrectomy, whole or portion of the stomach is removed.
• Reconnect the remaining parts of the digestive system, either directly or using a stoma bag to collect food waste outside of the body.
• Close up incision with sutures or staples and apply a dressing to protect it from infection.

• Check the patient's condition and fluid balance often.
• Provide postoperative pain relief as prescribed by the doctor.
• Keep an eye out for any indications of bleeding or infection.
• Encourage deep breathing exercises to help with lung expansion and reduce the risk of pneumonia or atelectasis (collapsed lung).
• Monitor for any signs of dumping syndrome, such as nausea, vomiting, diarrhea, sweating, dizziness or faintness after eating sugary foods or drinking liquids with sugar in them.
• Provide nutritional guidance to ensure adequate intake of vitamins and minerals following surgery due to the reduced stomach size that can affect nutrient absorption from food and drinks consumed.
• Assist with mobility activities to help prevent complications such as blood clots in legs or lungs (pulmonary embolism).
• Educate patient on lifestyle changes that will be necessary following surgery, such as avoiding smoking and drinking alcohol in excess, limiting caffeine intake, eating smaller meals more frequently throughout the day, chewing food thoroughly before swallowing it and avoiding heavy lifting activities for a period of time until full recovery is achieved from surgery

The cost of a gastrectomy in India can vary greatly depending on the type of procedure, the hospital or clinic you choose, and the location.

Generally speaking, a gastrectomy can cost anywhere between Rs. 50,000 to Rs. 2 lakhs in India.

• It's crucial to concentrate on eating nutrient-dense, easily digestible meals that are high in calories and protein after a gastrectomy.
• Healthy choices include lean meats, fish, eggs, dairy items, fruits, vegetables, whole grains, nuts, and seeds.
• In order to maintain proper hydration throughout the day, it is essential to consume a sufficient amount of fluids at regular intervals.
• Consuming meals that are more small in size but more often spaced out throughout the day is another strategy that may help maintain appropriate nutrition.
• Additionally, your doctor may recommend taking a multivitamin or other supplements to make up for any nutritional deficiencies.

Although there are certain dangers linked with having a gastrectomy performed, the surgery is considered to be very risk-free overall.

Infection, bleeding, and injury to the organs in the surrounding area are the most typical complications that might arise.

Patients may experience pain in the abdomen, chest, or shoulder area during or after the procedure.

Pain drugs are often recommended to enable patients manage any pain that may be associated with having a gastrectomy performed.

Recovery from gastrectomy can take anywhere from 4 to 8 weeks.

The length of time it takes to recuperate is dependent on the kind of surgery that was done as well as the individual's current state of health.

The gastrectomy procedure may have a variety of different aftereffects, depending on the kind of surgery performed and the person undergoing it. Some examples of common side effects include:

• Nausea and vomiting
• Diarrhea or constipation
• Bloating and gas
• Abdominal pain or discomfort
• Weight loss or gain
• Malnutrition due to decreased absorption of nutrients
• Dumping syndrome, a disorder in which food passes from the stomach to the small intestine too fast, causing nausea, vomiting, diarrhoea, stomach pain, and dizziness.
• Low blood sugar levels due to decreased absorption of glucose from food
• Fatigue due to nutrient deficiencies
• Changes in taste and smell

• After surgery, it is important for patients to follow their doctor’s instructions for proper aftercare in order to reduce the risk of complications.
• Patients should expect some pain and discomfort following the procedure.
• Pain medications can be prescribed by doctors to help manage this.
• Patients should also rest for at least two weeks after surgery to give their bodies time to recover appropriately.
• Patients should consume smaller, more regular meals during the day rather than heavy ones.
• Foods that are high in fiber and protein should be chosen over those that are high in fat or sugar.
• Additionally, fluids should be taken throughout the day in order to stay hydrated and prevent constipation due to lack of fiber intake from food sources.
• In addition, patients may need additional vitamin supplements such as iron and B vitamins due to decreased absorption rates after gastrectomy surgery.
• It is important for patients to discuss these needs with their doctor prior to surgery so they can make sure they have the necessary supplements on hand after the procedure has been completed.
• Finally, regular checkups with your doctor are essential following gastrectomy surgery in order to monitor progress and address any potential issues that may arise during recovery time.

Most of the times gastrectomy procedure is a success. The patient experienced minimal complications during the surgery and has been recovering well since.

The patient's symptoms have improved significantly and they are expected to make a full recovery in the coming weeks. The patient will need to visit their doctor on a regular basis to check their improvement.