Gastrectomy Overview

This is a surgery to remove all or part of the stomach.

Abdominal Organs, Anterior View © 2009 Nucleus Medical Media, Inc.

Prior to Procedure

Your doctor may do the following:

• Physical exam
• Blood tests
• Fecal occult blood test (FOBT)—a test to check for blood in the stool
• Endoscopy—a procedure that uses a scope with a camera on the end to examine the gastrointestinal system
• Upper GI series —a series of x-rays of the esophagus, stomach, and intestine during and after drinking a barium solution
• CT scan —a type of x-ray that uses a computer to make pictures of structures inside the body

Leading up to your procedure:

• Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure, like:

• Anti-inflammatory drugs (eg, aspirin )
• Blood thinners, like clopidogrel (Plavix) or warfarin (Coumadin)
• 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

The doctor will make an incision in your abdomen. Next, she will use surgical instruments 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 doctor will connect the remaining part of your stomach 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. The doctor will attempt to make a new “stomach” using your intestinal tissue. The end of your esophagus will be attached to your small intestine.

If you have stomach cancer, the doctor will likely remove and examine lymph nodes 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. Lastly, she will apply a dressing.

How Long Will It Take?

1-3 hours (or longer)

How Much Will It Hurt?

You will have pain during recovery. Ask your doctor about medicine to help with the pain.

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

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 medicines and vitamin supplements
• Make changes in your diet

Be sure to follow your doctor's instructions .

**RESOURCES:**

American Cancer Society
http://www.cancer.org/

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

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

**CANADIAN RESOURCES:**

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

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

References:

Stomach and esophageal cancer: what treatments are available? The Cancer Council Victoria website. Available at: http://www.cancervic.org.au/cancer1/patients/stomach/whattreatments.htm . Updated February 2008. Accessed September 3, 2009.

Stomach cancer: surgery. American Cancer Society website. Available at: http://www.cancer.org/docroot/CRI/content/CRI244XSurgery_40.asp?sitearea= . Updated May 2009. Accessed September 3, 2009.

Surgery to remove stomach cancer. Cancer Research UK website. Available at: http://www.cancerhelp.org.uk/help/default.asp?page=3917 . Updated December 2008. Accessed September 3, 2009.

What you need to know about stomach cancer. National Cancer Institute website. Available at: http://www.cancer.gov/cancertopics/wyntk/stomach/ . Published August 2005. Accessed September 3, 2009.