As a surgical procedure, gastrectomy involves removing all or part of the stomach to treat stomach cancer, but it can also be used for benign tumors, gastritis, peptic ulcers, obese patients, and traumatic injuries.
Gastrectomy is most commonly performed because of stomach cancer, a malignant tumor that grows in the stomach lining. In addition to spreading to nearby organs like the liver, pancreas, and spleen, stomach cancer may also spread to distant organs such as the lungs, bones, and brain. It is unknown what causes stomach cancer, but some risk factors include:
Helicobacter pylori infection, a type of bacteria that can cause chronic inflammation and ulcers in the stomach.
Smoking, which can damage the cells of the stomach lining and increase the risk of mutations.
Diet, especially eating foods that are high in salt, smoked, pickled, or preserved, or low in fruits and vegetables.
Family history, especially having a genetic mutation in the CDH1 gene, which increases the risk of hereditary diffuse stomach cancer.
Other causes of gastrectomy include:
Benign stomach tumors, which are noncancerous growths that can cause symptoms or have the potential to become malignant.
Gastritis, which is inflammation of the stomach lining that can cause pain, nausea, vomiting, and bleeding.
Peptic ulcer disease, which is a condition where sores or ulcers form in the stomach or the first part of the small intestine (duodenum).
Obesity, which is a chronic condition where excess body fat accumulates and affects health and quality of life.
Injuries, which can damage the stomach tissue and cause bleeding, infection, or perforation.
The symptoms of gastrectomy depend on the type and extent of the surgery, as well as the underlying condition that necessitated it. Some common symptoms include:
Weight loss, due to reduced food intake and absorption.
Nausea, vomiting, and diarrhea, due to changes in the digestive system and food tolerance.
Dumping syndrome, which is a condition where food moves too quickly from the stomach to the small intestine, causing cramps, bloating, dizziness, and sweating.
Anemia, which is a condition where the red blood cells are low in number or function, causing fatigue, weakness, and shortness of breath.
Vitamin and mineral deficiencies, especially vitamin B12, iron, calcium, and magnesium, due to reduced absorption and supplementation needs.
Reflux, which is a condition where stomach acid or bile flows back into the esophagus, causing heartburn, chest pain, and coughing.
The diagnosis of gastrectomy involves a thorough medical history, physical examination, and various tests and procedures, such as:
Blood tests, to check for anemia, infection, inflammation, and nutritional status.
Endoscopy, which is a procedure where a thin, flexible tube with a camera and a light is inserted through the mouth and into the stomach to examine the lining and take biopsies (tissue samples) if needed.
Imaging tests, such as X-rays, ultrasound, computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET), to visualize the stomach and other organs and detect any abnormalities or spread of cancer.
Staging, which is a process of determining the extent and severity of cancer based on the size and location of the tumor, the involvement of nearby lymph nodes, and the presence of distant metastases.
The treatment of gastrectomy depends on the type and extent of the surgery, as well as the underlying condition that necessitated it. Some common treatments include:
Surgery, which is the main treatment for stomach cancer and involves removing all or part of the stomach, as well as some nearby tissue, such as the lymph nodes, spleen, pancreas, or part of the esophagus or small intestine. There are two main types of gastrectomy:
Total gastrectomy, which removes the entire stomach and connects the esophagus directly to the small intestine.
Partial gastrectomy, which removes part of the stomach and leaves the remaining portion attached to the esophagus and the small intestine.
Chemotherapy, which is a treatment that uses drugs to kill cancer cells or stop them from growing and spreading. It can be given before or after surgery, or as the main treatment if surgery is not possible or effective.
Radiation therapy, which is a treatment that uses high-energy rays or particles to destroy cancer cells or shrink tumors. It can be given before or after surgery, or as the main treatment if surgery is not possible or effective.
Immunotherapy, which is a treatment that uses substances that stimulate the body’s immune system to fight cancer cells. It can be given alone or in combination with other treatments, depending on the type and stage of cancer.
Targeted therapy, which is a treatment that uses drugs that target specific molecules or genes that are involved in the growth and survival of cancer cells. It can be given alone or in combination with other treatments, depending on the type and stage of cancer.
Bariatric surgery, which is a type of weight loss surgery that reduces the size or function of the stomach, such as gastric sleeve, gastric bypass, or gastric banding. It can help people with obesity lose weight and improve their health and quality of life.
Medications, which can help manage symptoms and complications of gastrectomy, such as pain, nausea, vomiting, diarrhea, reflux, dumping syndrome, anemia, and vitamin and mineral deficiencies.
Dietary and lifestyle changes, which can help improve recovery and quality of life after gastrectomy, such as:
Eating small, frequent meals and avoiding foods that are high in fat, sugar, or fiber.
Drinking fluids between meals and avoiding alcohol and caffeine.
Taking vitamin and mineral supplements as prescribed by the healthcare provider.
Avoiding lying down or bending over after eating and elevating the head of the bed at night.
Quitting smoking and limiting exposure to secondhand smoke.
Exercising regularly and maintaining a healthy weight.
Seeking emotional and social support from family, friends, or support groups.
The prevention of gastrectomy involves reducing the risk factors for the conditions that may require it, such as:
Stomach cancer, which can be prevented by:
Treating Helicobacter pylori infection with antibiotics and acid-suppressing drugs.
Avoiding smoking and limiting exposure to secondhand smoke.
Eating a balanced diet that is rich in fruits and vegetables and low in salt, smoked, pickled, or preserved foods.
Limiting alcohol consumption and avoiding excessive drinking.
Having regular screening tests, such as endoscopy and biopsy, especially for people with a family history or genetic mutation that increases the risk of stomach cancer.
Benign stomach tumors, gastritis, and peptic ulcer disease, which can be prevented by:
Treating Helicobacter pylori infection with antibiotics and acid-suppressing drugs.
Avoiding smoking and limiting exposure to secondhand smoke.
Eating a balanced diet that is rich in fruits and vegetables and low in salt, spicy, or acidic foods.
Limiting alcohol consumption and avoiding excessive drinking.
Taking nonsteroidal anti-inflammatory drugs (NSAIDs) with caution and only as prescribed by the healthcare provider.
Managing stress and practicing relaxation techniques, such as meditation, yoga, or breathing exercises.
Obesity, which can be prevented by:
Eating a balanced diet that is low in calories, fat, sugar, and processed foods and high in protein, fiber, and water.
Controlling portion sizes and avoiding overeating or binge eating.
Exercising regularly and engaging in physical activities that burn calories and increase metabolism.
Seeking professional help for any underlying medical or psychological conditions that may contribute to obesity, such as hypothyroidism, depression, or binge eating disorder.
Consulting with a healthcare provider before starting any weight loss program or taking any weight loss supplements.
Injuries, which can be prevented by:
Wearing seat belts and following traffic rules when driving or riding in a vehicle.
Avoiding contact sports or activities that may cause trauma to the abdomen.
Seeking immediate medical attention for any abdominal pain, bleeding, or signs of infection.
