What Is a Gastrectomy?

If you have stomach cancer, your doctor may suggest taking out part or all of your stomach. Although this will change how you digest food, you’ll still be able to eat and drink. The surgery can also stop your cancer from spreading and prevent it from coming back.

Who Needs It?

It’s often part of the treatment for stomach cancer. Depending on where the cancer is in your stomach and how far it has spread, your surgeon will decide what type of treatment you need.

A total gastrectomy means the doctor will remove your entire stomach. Sometimes he only needs to take out part of your stomach. He’ll call this subtotal, or partial, gastrectomy.

Even if he can’t remove all of the cancer, a partial gastrectomy may provide some relief. It isn’t a cure, but it can ease symptoms like pain and bleeding.

Who Shouldn’t Have a Gastrectomy?

Your doctor will look at the type and stage of your cancer as well as any other health problems you have. Some, like anemia and hypoproteinemia (low protein levels in your blood), make it more likely you’ll have severe problems after this surgery.

What Happens in a Gastrectomy?

You’ll need to go to the hospital for a gastrectomy. It can take between 4 to 5 hours if the doctor makes a large incision (a cut) to remove your stomach. Or he can make several small cuts, called laparoscopic gastrectomy. It takes less time, but it isn’t as widely used.

First, you’ll get anesthesia so you sleep through the procedure. Once you’re under, a surgeon will make an incision in your belly. Through this, he’ll remove part or all of your stomach, as well as some nearby tissue like your nymph nodes. He’ll test the nodes to make sure the cancer hasn’t spread. It’s key that your doctor remove as much of the cancer as he can.

Depending on the type of procedure you have, the surgeon will decide the best way to rebuild your digestive tract.

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What’s Life Like After a Gastrectomy?

This is major surgery, so it’ll take some time for you to feel better. You’ll be in the hospital for about 4 days.

For the first few days, you won’t be able to eat any food. Then you’ll be on a clear liquid diet. This gives your digestive tract a chance to heal. Instead, you’ll be fed through an IV in your vein or a catheter (tube) that goes into your belly. After about a week, you should be ready to start a light diet again.

Because your stomach is smaller now, be prepared to make some changes to how you eat:

Small meals throughout the day. Six small meals will be easier for you to digest than three large ones.

Drink and eat at different times. Have fluids 1 hour before or after meals instead of during them.

Watch your fiber intake. High-fiber foods like beans, lentils, and whole grains can fill you up too fast. Add them back slowly.

Go easy on dairy. After this surgery, many people can’t digest lactose, the sugar in milk. If you’re one of them, you’ll have gas, bloating, and diarrhea after you have dairy foods.

Take a supplement. Some nutrients like iron, calcium, and vitamins B12 and D are harder for your body to absorb from food after a gastrectomy. Your doctor may do blood tests to check these levels. If they’re low, you may need to start taking a supplement.

Are There Any Side Effects?

You could get what’s called dumping syndrome. When your small intestine has to digest a large amount of food at once, you may throw up or have nausea, cramps, or diarrhea. Many people notice these symptoms within an hour of eating.

If you feel sick a few hours later, your blood sugar may be rising and falling too fast. It’s common to sweat, have a fast heart rate, or feel tired or confused.

Changing what you eat can help you manage these symptoms. Remember, too, to be patient. After your gastrectomy, it may take 3 to 6 months to adjust.

WebMD Medical Reference Reviewed by Neha Pathak, MD on September 19, 2017

Sources

SOURCES:

Memorial Sloan Kettering Cancer Center: About Your Gastrectomy Surgery,” “Eating After Your Gastrectomy or Esophagogastrectomy.”

NHS Choices: “Gastrectomy,” “Gastrectomy Recovery.”

UpToDate: “Partial gastrectomy and gastrointestinal reconstruction,” “Total gastrectomy and gastrointestinal reconstructionTotal gastrectomy and gastrointestinal reconstruction.”

American Cancer Society: ‘Surgery for Stomach Cancer.”

Medscape: “Partial gastrectomy.”

No Stomach for Cancer: “Total Gastrectomy (Complete Removal of Stomach).”

Mayo Clinic: “Stomach Cancer: Treatment.”

Practical Gastroenterology: “Post-Gastrectomy: Managing the Nutrition Fall-Out.”

Cancer Treatment Centers of America: “Total gastrectomy for stomach cancer.”

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