Gastrectomy

Gastrectomy

Gastrectomy or body subject to gastrectomy will affect the efficiency of the digestive system, despite its importance, which will cause the body to need supplementary nutrition from the outside.

Each organ of the human body has a particular function, that it is dispensed with, or eradicated, that does not restore the body to what it was. Even if it is replaced by another member; the efficiency of the organ that is part of any organ will never be back.

In this article, we talk about gastrectomy, its methods and complications, and about the diet after gastrectomy, which will inevitably change. It has the primary function of digesting and absorbing food after losing part or all of the stomach.

What is the meaning of gastrectomy?

Gastrectomy is a procedure that surgeons take, which includes total or part of gastrectomy through surgery. Gastrectomy is divided into four types:

  • First: Total gastrectomy: It is a complete gastrectomy, in which the entire stomach is removed.
  • Second: Partial gastrectomy: In this procedure, the lower part of the stomach is removed.
  • Third: esophageal gastrectomy: In this procedure, a portion of the esophagus is removed with the upper part of the stomach.
  • Fourth: Sleeve gastrectomy: Sleeve gastrectomy is a gastrectomy of the left part of the stomach.

What happens during the surgery?

The stomach is located in the middle region of the digestive system between the esophagus from the top, the small intestine from the bottom. During the Gastrectomy process, the esophageal surgeon connects the duodenum if there is total Gastrectomy, or the esophagus connects to the rest of the stomach if the Gastrectomy is partially eradicated. That means that the digestive system will continue to function, but with a lower quality than before the eradication.

What are the main causes?

Doctors resort to Gastrectomy in the following cases:

  1. Stomach cancer.
  2. Cancer of the esophagus.
  3. The threat of obesity to the patient's life.
  4. Benign tumors inside the stomach.
  5. Gastrectomy is done if there any stomach ulcers or (peptic ulcers) are present.
  6. Incidence of bleeding inside the stomach.
  7. The presence of inflammation.

Pre-gastrectomy procedures

  • Stop smoking: the doctor will ask the patient to stop smoking before Gastrectomy, and he should stop smoking forever after surgery; it causes slow recovery, and increases the risk of health problems.
  • The patient, if a female, must inform her doctor, or any member of the medical staff, that she is pregnant or suspects of pregnancy, before performing a Gastrectomy.
  • The physician must be aware of the medications the patient is taking, in addition to herbs, vitamins, and all the nutritional supplements that the patient receives.
  • A week before Gastrectomy, the surgeon may ask the patient to stop taking medications that are causing the blood clotting; Examples: Warfarin and Heparin.
  • On the day of surgery, the patient should refrain from eating and drinking after midnight the night before the Gastrectomy.
  • On the day of surgery, the patient also has to take the medications prescribed by the doctor, with a small sip of water drunk.

Complications

First

For patients with stomach cancer, the risk of complications increases. Because most stomach cancer patients are older adults with health problems, and when a Gastrectomy to treat stomach cancer, the following complications may occur:

  • The patient was infected.
  • Narrowing of the esophagus; Due to the formation of scars inside the esophagus as a result of leakage of stomach acid into the esophagus.
  • A complication of Gastrectomy is a leak that occurs from the place the surgeon closes the stomach or the place where the stomach is reconnected to the small intestine.
  • Possibility of infection in the patient's chest.
  • The small intestine may become obstructed.
  • Risks also include internal bleeding.
  • The risk of death during Gastrectomy surgery to treat stomach cancer is 2%, statistics indicate.

It is possible to treat the infection - if it occurs - with antibiotics, while the rest of the complications may not be cured except with another surgical intervention.

Second

For obese patients:

Complications of Gastrectomy for obesity treatment include:

  • Blood clots form as a result of internal bleeding.
  • Vomiting and nausea, which improves over time.
  • The infusion may occur from the place the stomach was closed.
  • The acid may return from the stomach to the esophagus after a Gastrectomy.
  • Symptoms include the risk of infection.
  • Studies indicate that the risk of death occurs at a meager rate, not exceeding one percent.

General complications

When the stomach is completely removed, the body may not be able to obtain the essential vitamins, vitamin B12, D, and C; because the absorption of these vitamins is mainly a function of the stomach, and this causes health problems:

  • Anemia; because the production of healthy blood cells requires vitamin B12, and thus the patient shows symptoms of anemia, namely: difficulty breathing, fatigue, and exhaustion. After Gastrectomy, the patient feels an uncomfortable fullness again and may cause weight loss. And this considered a positive factor if Gastrectomy is to treat obesity. The patient should see a dietitian; to adjust the diet to ensure weight gain without exhausting its digestive system.
  • May cause water from entering the intestine to digest sugars instead of the stomach in Dumping syndrome, which means that the intestine withdraws water from all parts of the body to break down nutrients (sugars and starches). The intestine gets excess water from the blood; this results in a sudden drop in blood pressure.
  • There is a possibility that some patients will exposed to what known as morning vomiting, and this occurs after partial Gastrectomy. Morning vomiting results when the bile and digestive juices gather in the region of the first sector of the small intestine (duodenum), with a diminished stomach volume the patient feels the desire to vomit. To get rid of excess fluids, and there is a drug that can used in this framework. To relieve morning vomiting, which is aluminum hydroxide.
  • Vagus nerve segmentation - whose function is to control the movement of food as it passes through the digestive system - causes some people diarrhea attacks. Because the vagus nerve heals after surgery, an anti-diarrheal drug can be used to reduce diarrhea attacks, like Loperamide, every morning.
Complications related to Vitamins
  • Vitamin C contributes to strengthening the immune system, and a deficiency in it as a result of Gastrectomy leads to infections and the slow healing of wounds and infections.
  • Vitamin D is vital for maintaining muscle and bone health, and its deficiency - caused by Gastrectomy - causes osteoporosis and muscle weakness. The treatment for this condition is the use of nutritional supplements (vitamin supplements).

Gastrectomy for obesity

The Gastrectomy process for this purpose is the most challenging process for treating obesity. Through it, stomach gagging occurs, and the reason for weight loss after that is that it creates a severe stop in the absorption of fats and starch, and this happens because, during the operation, surgeons separate the pancreas and the yellow juice from the food that is digested.

Although after the operation, the patient eats more food than before. Its weight is greatly reduced and decreases, it is the most significant Gastrectomy for this purpose.

Disadvantages of gastrectomy

Stomach removal surgery has some drawbacks:

  • Complexity and length of the process.
  • After the operation, an absorption disorder occurs. It requires the patient to take at least ten vitamins, iron, and calcium tablets daily, and he may need a weekly injection. Gastrectomy to lose weight requires constant analysis for the rest of life and even special medical attention.
  • Excessive, foul-smelling wind, caused by the post-operative imbalance in the fat digestion process.
  • The process causes diarrhea, four to six times daily.

Gastrectomy methods

The patient does not feel any pain as a result of performing this surgery whether it is Gastrectomy with open surgery or by laparoscopic Gastrectomy because both methods performed under the influence of the total anesthetic.

First: the method of open surgery

In this process, the specialist surgeon opens one large opening in the patient's abdomen and then displaces everything on his way to the stomach.

Including muscles, tissues, and skin, to reach the stomach. The surgeon may choose this method of Gastrectomy surgery, instead of the second method that will mentioned, to treat cancerous stomach tumors.

Second: Laparoscopic Gastrectomy

It is the most appropriate solution for most cases, and surgeons resort to it because the complications of Gastrectomy are less, and the recovery and recovery period is faster. As it is newer, more accurate, and more developed.

Surgeons during laparoscopic Gastrectomy don’t infringe the patient's body excessively, as in open surgery. The surgeon opens small wounds to the patient's abdomen, through which endoscopic surgical instruments are inserted, and this process is called a keyhole.

How long does gastrectomy take?

The Gastrectomy takes time determined by the size of the cancerous tumor, the experience of the surgeon or the medical team operating, and the patient's condition.

Post-gastrectomy procedures

After Gastrectomy, surgeons close the surgical opening with the appropriate thread, then place the medical dressings on the wound areas, and transfer them to the hospitals' recovery rooms.

  • The medical team accompanying the surgeons monitors the vital functions of patients during the recovery and recovery periods in hospitals.
  • Patients who have had a Gastrectomy may stay up to two weeks.
  • During a hospital stay, doctors install a patient's tube from the nose to the stomach, and this tube allows the fluid produced by the stomach (the rest of it, or the location of the surgery) to get rid of, and this method protects patients from nausea.
  • Getting proper nutrition after Gastrectomy is by intravenous injection until the patient regains their ability to eat and drink as normal.
  • The patient will have to inform his physician of any health problems he may be experiencing or feel the pain that is difficult to tolerate according to the prescribed medications.
  • Patients who have had a Gastrectomy should refrain from engaging in moderate or intense activities during the four or six weeks after surgery.
  • The patient forbidden to drive vehicles; if he is taking pain medication; it contains an anesthetic.

Food system after the surgery

The food system after Gastrectomy will change; because it is the stomach that primarily performs the process of digesting food. And the stomach transforms food into a semi-liquid substance directed to the small intestine; to complete the digestion and absorption.

Although Gastrectomy has several types, then the diet will change from before, and it may take months after Gastrectomy, without returning to its usual and regular food. So anyone has to adapt to a new diet, which the surgeon and nutritional specialist will set for him.

The foods that the patient takes before the operation will cause dyspepsia after the surgery, so he should record the foods that cause him to indigestion in a particular book; to avoid eating in the future.

It is preferable for the patient in the diet after Gastrectomy to eat many small meals instead of the usual three large meals, and after a while, he will be able to eat meals slightly more substantial, and less in number.

Food that the patient can eat

First: minerals and vitamins
  • The patient should have access to vitamins C, D, iron, and calcium; To protect it from the following symptoms:
  1. Weakened immune system.
  2. Anemia.
  3. Osteoporosis or osteoporosis.

If the patient underwent total gastrectomy, he would not be able to obtain minerals and vitamins from his diet after gastrectomy. He forced to take nutritional supplements.

  • Most patients who have had a complete Gastrectomy, and some patients who have had a partial Gastrectomy, will injected monthly with a vitamin B12 injection. Because gastric juice can manufacture vitamin B12; the digestive system's inability to make this vital vitamin needs to compensated for.
  • Patients who undergo Gastrectomy will have to take vitamins from outside the body for life. The function of the stomach stopped. Which is the absorption of minerals and vitamins from food.
  • The patient will subjected to a continuous blood test. For the doctor to ensure that he is continuously getting vitamins and minerals. Because unbalanced nutrition will lead to health problems; For example, anemia.
Second: sweets

Sweets, sugar, fruit juice, jelly, jam, chocolate, canned fruits and cakes, soft drinks and honey, are all forbidden by the patient, who underwent Gastrectomy.

Third: Fat

Patients who have undergone this surgery have difficulty digesting fats. Therefore, the nutritionist and physicians directed to gradually introduce it to the body so that they can monitor the degree of body acceptance. These fats found in these sources:

  • Milk products full cream milk.
  • Liquid cheese.
  • Mayonnaise.
  • Butter.
  • Oils.
Fourth: Milk products

Lactose-free milk products are the ultimate solution if the patient cannot tolerate skim or yogurt products. It also prevents the patient from eating ice cream and milkshakes.

Fifth: vegetables and fruits

The patient can eat both bananas and watermelons which the seeds have removed, and he can eat vegetables cooked or peeled, and he should avoid fresh fruits and their juice. Because it may feel difficult to digest fresh vegetables and fruits.

Sixth: Grains and starches

In the food system after the surgery, it recommended to eat white rice and white bread and avoid foods rich in fiber and legumes. Such as lentils, beans, brown rice, pasta, and brown bread.

Seventh: Proteins

The food system after the stomach removal should eaten protein every day and every meal. It slows down digestion and contributes to the speed of patient recovery after this surgery. But eating protein should be in the form of easy-to-chew meat. Like chicken meat, fish, cheese, peanut butter, or eggs, and stay away from hard-to-chew meat.

obesity

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