Background
Gastric adenocarcinoma is the fourth leading cause of cancer death in the United States, affecting approximately 22,000 patients annually in the United States, with more than 14,000 deaths per year.
Despite advances in multimodality treatment for gastric cancer, as well as curative resection, recurrence and mortality remains high. This may be due in part to a late stage when diagnosed. In countries like Japan, South Korea and China, the rate of cancer of the stomach in the range 38-55 100,000 people died. In the United States the incidence of gastric cancer is lower, but still at 1.1 million per year. Japanese and Korean scientists have developed two techniques for the detection and minimal access approaches to the treatment of early gastric cancer. In the United States, and even less of patients with the disease at an early stage.
There are three main types of Gastrectomy:
• The partial gastrectomy involves removing part of the stomach. Usually, it is the lower half, which is removed.
• Total gastrectomy is the removal of the entire stomach.
• Gastrectomy is the removal of the left side of the stomach. This is usually done as part of a weight loss surgery.
• Eliminating stomach does not diminish their ability to digest food and liquid. However, you may need to make a few changes in lifestyle after the procedure.
Why you might need Gastrectomy?
Gastrectomy is used for treating stomach problems are not helped other treatments. Your doctor may recommend gastrectomy for the treatment of:
Benign or non-cancerous,
Bleeding
Inflammation
Perforations in the walls of the stomach
Polyps or tumors in the stomach
Stomach cancer
Severe peptic ulcer or duodenal
Some types of gastrectomy are used to treat obesity. By making the stomach smaller, which heals up quickly. It can help you eat less. However, gastrectomy for obesity treatment applied only when other options have failed. Less invasive treatments include:
Exercise
Medicines
Consultation
Preparing for gastrectomy
Diagnosis
Your doctor may order blood tests and X-rays for you before surgery. They will ensure that you are healthy enough for the procedure. A complete physical examination and review your medical history is also performed. During your appointment, tell your doctor if you are taking medication. Be sure to have excess counter medications and supplements. You may need to stop taking certain medications before surgery. You should also inform your doctor if you are pregnant, think you might be pregnant or have other medical conditions such as diabetes. If you smoke, stop. Smoking adds additional time to recover. You can create more complications.
Gastrectomy risks include:
Acid reflux
Diarrhea
Dumping syndrome, a severe form of maldigestion
Infection incision wounds
Chest infection
Internal bleeding
Leak stomach at the workplace
Disease
Vomit
Stomach acid escapes into the esophagus, causing scarring, narrowing or constriction (stenosis)
Small bowel obstruction
Vitamin A deficiency
Weight loss
Be sure to tell your doctor your medical history and medication. Follow all instructions given to him in preparation for the procedure. This will reduce your risks.
How gastrectomy is performed? Procedure:
There are two different ways to start gastrectomy. Everything is done under general anesthesia. This means that you will be in a deep sleep during surgery and will be unable to feel pain. Open surgery involves a large incision. The surgeon will remove the skin, muscles and tissues to access the stomach.
Laparoscopic Operation
Laparoscopic operation is a slightly invasive surgery. Small incisions and specialized tools used. It is less pain and faster recovery time. It is also known as "key-hole surgery" or Laparoscopically Assisted Gastrectomy. LAG is generally preferred to open surgery. This is a more advanced operation with low complication rate. Your surgeon may recommend open surgery to laparoscopic surgery in the treatment of certain diseases such as cancer of the stomach.
Types Gastrectomy
Partial gastrectomy: The surgeon removes the lower part of the stomach. The surgeon may remove nearby lymph nodes for cancer cells in them. In this surgery, the surgeon will close the duodenum. Your duodenum is the first part of the small intestine that receives partially digested food in the stomach. Then the remaining part of your stomach will connect to your stomach.
Total gastrectomy: Also called a total gastrectomy, this procedure completely removes the stomach. Your doctor will connect directly to the esophagus to the small intestine. The esophagus usually connects the throat to the stomach.
Sleeve gastrectomy: Up to three quarters of the stomach can be removed during the sleeve gastrectomy. The residue is stopped and sews. This creates a smaller, more stomach.
After gastrectomy
After gastrectomy, the doctor will close the incision with stitches and the wound is bandaged. You will be taken to the hospital room to recover. A nurse will monitor your vital signs all the time. You can expect to stay in hospital for one or two weeks after surgery. During this time, it is possible that the nasal gastric tube. This allows the doctor to remove all the liquid produced by the stomach should be removed. It helps to prevent nausea. You will be fed through a tube into a vein until it is ready to eat and drink normally.
Gastrectomy recovery may take a long time. At the end of your stomach and small intestine stretch. Then you will be able to consume more fiber and eat larger meals. You need to have regular blood tests after the procedure to make sure you get enough vitamins and minerals.
Conclusion
Open with minimal lymph node dissection of 15 to gastrectomy for staging still appropriate surgical treatment of gastric adenocarcinoma in the West. With increasing experience and expertise of oncology surgeons in minimally invasive approach for resection of gastric cancer, it becomes clear that laparoscopy as resection technique offers an equivalent resection with lymphadenectomy equivalent comparable open access, without compromising repetition or Long-term survival based on preliminary studies. Furthermore, based on the known benefits of the minimally invasive surgical trauma, blood loss, pain reduction and faster recovery of the patient, we are encouraged to expand its indications for this approach. It has also been fueled by advances in minimally invasive surgery Mild abdominal diseases, and the results of several oriental studies early stage cancer. Although the open approach should be applied in all cases related to it.
