For each generation of people, life dictates its own rhythm. In order to be in time everywhere, the modern person has to sleep less, refuse breakfast or lunch, have a snack on the run. All this negatively affects the condition of the stomach. A late appeal to the doctor complicates the situation. If drug treatment is not able to cope with the problem, you have to resort to radical measures. Such measures are operations on the stomach.
What is the stomach and what are its functions
The stomach is a special organ in the form of a hollow muscle sac intended for the intake and digestion of food. This organ is located under the esophagus. Its lower part passes through the pyloric sphincter into the duodenum. An empty stomach has a volume within 0.5 liters. After eating, it increases to 1 liter, but can withstand overeating and stretch to 4 liters.
In addition to storing the received food, the functions of the stomach include:
- mechanical processing of food mass;
- promotion of food in the next section of the intestine;
- chemical effects on food by enzymes of gastric juice;
- the allocation of elements that contribute to the absorption of vitamin B12;
- nutrient absorption;
- disinfection of food mass with hydrochloric acid;
- hormone production.
In order to continuously perform its functions, the body must be healthy. It is important to pay attention to changes in taste, heartburn, pain and nausea in time to avoid surgery on the stomach.
Common diseases of the stomach
Most often, doctors are treated with chronic gastritis, duodenitis, erosion, an ulcer and oncological neoplasms. Each disease is more or less dangerous and requires qualified treatment. The patient must fully comply with the doctor’s prescription and follow all recommendations so that you do not have to visit the surgery unit.
Types of operations. Resection
In medical practice for diseases of the stomach, several types of surgical interventions are used. These are resection, gastrectomy, gastroenterostomy, vagotomy. Each operation has its own indications and contraindications and requires a certain qualification from the surgeon.
The resection of the stomach is the removal of some part of the organ with the subsequent restoration of the continuity of the esophagus tube. Similar operations on the stomach are prescribed for cancer, an ulcer or a high degree of obesity. The operation requires a comprehensive diagnosis and certain preparation of the patient. In addition, the development of postoperative complications is possible.
Depending on the complexity of the disease, the doctor selects the type of resection. It could be:
- Complete removal of the stomach.
- Removal of part of an organ near the esophagus, i.e. proximal resection.
- Removal of the lower organ sector in front of the duodenum, i.e., distal resection.
- Sleeve removal in obesity.
Most often, proximal and distal surgery are performed. In this case, resection of the stomach involves hemming the organ stump to the esophagus (proximal) or small intestine (distal). Such resections take more than 2 hours from a specialist.
Gastric ulcer resection
Most often, a stomach ulcer can be treated on an outpatient basis. But sometimes drug treatment does not give a result. An operation for an ulcer is prescribed in the following cases:
- With cicatricial narrowing of the pyloric sphincter (pyloric stenosis).
- With the spread of pathology beyond the stomach (generation).
- During perforation (appearance of a through hole).
- With the advanced form of ulcers with large sizes and a large depth of tissue damage.
In addition, surgery on the stomach can be prescribed if the patient has bleeding that cannot be controlled medically. The reason for the resection may be frequent relapses of the disease.
Cancer resection
Gastroenterologists and oncologists are often consulted by patients with cancerous tumors. Gastric cancer is considered the most common form of cancer. Surgery for gastric cancer may not require partial resection, but complete organ removal. This operation is called gastrectomy. Formally, this is a type of resection, but the manipulation is more complex, and the negative impact on the patient is more pronounced.
With gastrectomy, not only the stomach is removed, but also two omentums, and lymph nodes. Complete removal of the stomach involves direct connection of the esophagus with the jejunum. An artificial joint (anastomosis) is performed by a double-row intestinal suture.
After the operation, chemical and mechanical processing of food is not performed. This requires strict diet and even distribution of meals throughout the day. Servings should be small, complex fats and difficult to digest foods are completely excluded from the menu.
With a complete gastrectomy, the laparoscopic method is almost never used. A traditional open technique is used in which a large incision is made. The patient needs several weeks to recover from surgery. After awakening from anesthesia, the patient does not drink or eat. They put a urinary catheter and a nasogastric tube, sometimes breathing through a mask.
The patient begins to give water only after the appearance of peristaltic sounds. If the body normally responds to fluid, then they begin to give soft foods.
Resection for obesity
With a high degree of obesity, in some cases, a longitudinal resection is prescribed. Sometimes called a sleeve removal procedure. The operation cuts off most of the stomach, but retains physiological valves. As a result, the volume of the organ decreases, but the digestion process is not disturbed. The stomach no longer looks like a muscular sac, it looks like a narrow tube, the volume of which is about 150 ml. A dramatic weight loss and a decrease in hunger are occurring, as the hormone producing zone responsible for this feeling is removed. Longitudinal resection allows you to lose up to 60% of excess weight, while no foreign objects, such as a balloon or bandage, are placed in the stomach. This method of treating obesity can be used at any age.
Gastroenterostomy
With some indications, gastric resection is impossible. This applies to the elderly, weak patients, cases of cicatricial stenosis due to a burn of the stomach and inoperable cases of cancer. Such patients undergo gastroenterostomy. During the operation, an anastomosis is formed between the cavity of the stomach and the small intestine.
The operation helps to relieve the stomach, speed up the evacuation of food and restore patency. However, it gives a lot of complications, so it is performed only in the absence of other treatment options.
Vagotomy
Another way to treat a stomach ulcer is vagotomy. This is an operation involving the dissection of the vagus nerve. As a result of the manipulation, nerve impulses cease, on which the production of gastric juice depends. The gastric contents are reduced acidity, resulting in healing of ulcers.
For the first time, a patient was delivered to the operating unit for a vagotomy in 1911. This was reported at the Berlin Surgical Congress. Since 1946, the operation has been put on stream.
Since 1993, the number of vagotomies has declined sharply, since drugs that block acid production have become widely used.
Operation cost
The cost of the same manipulation in different countries, and even in the regions of the same country, can vary significantly. It all depends on the complexity of the disease, the location of the pathology, the qualifications of the surgeon or oncologist, as well as the technical equipment of the clinic. All issues are resolved during consultation with specialists. Most often, the cost of the operation includes hospital stay, anesthesia and postoperative care.
In recent years, people with serious obesity problems have resorted to surgeons. To cope with excess weight allows the operation of longitudinal resection of the stomach. Its average cost in Russia is about 140,000 rubles.