This surgery is essentially performed when treating stomach cancer (apart from vertical gastrectomies in obesity surgery) and benign tumours with uncertain prognostics.
There are two types :
Wedge resection gastrectomies
They are usually performed by coelioscopy, in the case of benign tumors or if their is a future risk of cancer. The damaged tissues are removed with a safety margin, but their is no node dissection (removal of nodes around the stomach). The main indication is the GIST (gasto intestinal stroma tumoral), a benign tumour of the stomach submucosa, but which has a risk of degenaration (carcinogenesis) dependant especially on the size of the tumour.
Gastrectomies with node dissection
They can bu subtotal (4/5 of the stomach) or total (removal of all of the stomach). They are associated with the removal of nodes around the stomach (dissection). They can be predecessed by chemotherapy. These necessary stomach operations can imply higher risks and possible sequelae:
–hemorragy, requiring transfusion and/or intervention
–intra-abdominal collection and/or peritonitis in relation with the anastomotic fistulas (if the stitches fail to heal), which can require longer intravenous feeding, antibiotics, radiologic draining or further surgery. These complication can endanger vital prognostics.
–diarrhoea because of a severed vagus nerve (near the lower part of the oesophagus)
–dumping syndrome : a general feeling of discomfort following a meal (usually major gastrectomies)
–loss of weight following gastrectomy (usually 10% of body weight); step feeding (6 small meals per day) can be necessary because of the loss of the reserve function of the stomach
-long term (15 to 20 years later), cancer of the gastric stump
-requires a nutritional follow-up programme and a monthly B12 vitamin therapy for the rest of life