Life dictates its rhythm to each generation of people. In order to be in time everywhere, a modern person has to sleep less, refuse breakfast or lunch, and have a snack on the run. All this negatively affects the condition of the stomach. And late treatment to the doctor complicates the situation. If drug treatment is not able to cope with the problem, you have to resort to drastic measures. Such measures are stomach surgeries.
What is the stomach and what are its functions
The stomach is a special organ in the form of a hollow muscular sac designed to receive and digest 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 of 0.5 liters. After eating, it increases to 1 liter, but can withstand overeating and stretch up to 4 liters.
In addition to storing the received food, the functions of the stomach include:
- mechanical processing of food mass;
- promotion of food to the next section of the intestine;
- chemical effect on food by gastric juice enzymes;
- isolation of elements that contribute to the absorption of vitamin B12;
- absorption of nutrients;
- disinfection of food mass with hydrochloric acid;
- production of hormones.
To perform its functions smoothly, the body must be he althy. It is important to pay attention to taste changes, heartburn, pain and nausea in time to avoid stomach surgery.
Common Stomach Diseases
Most often, doctors are treated with chronic gastritis, duodenitis, erosion, ulcers and oncological neoplasms. Each disease is more or less dangerous and requires qualified treatment. The patient must fully comply with the doctor's prescriptions and follow all recommendations so that they do not have to visit the operating unit.
Types of operations. Resection
In medical practice, several types of surgical interventions are used for diseases of the stomach. These are resection, gastrectomy, gastroenterostomy, vagotomy. Each operation has its own indications and contraindications and requires certain qualifications from the surgeon.
Resection of the stomach is the removal of some part of the organ with the subsequent restoration of the continuity of the esophageal tube. Similar operations on the stomach are prescribed for cancerous growths, an ulcer, or a high degree of obesity. The operation requires complex diagnostics and certain preparation of the patient. In addition, postoperative complications may develop.
Depending on difficultydiseases, the doctor selects the type of resection. It could be:
- Total removal of the stomach.
- Removal of a part of the organ near the esophagus, that is, proximal resection.
- Removal of the lower sector of the organ in front of the duodenum, that is, distal resection.
- Sleeve removal for obesity.
Most often performed proximal and distal surgery. Resection of the stomach in this case involves suturing the organ stump to the esophagus (proximal) or small intestine (distal). Such resections take more than 2 hours from a specialist.
Resection for gastric ulcer
Most often, a stomach ulcer can be cured on an outpatient basis. But sometimes medical treatment does not work. Ulcer surgery is indicated in the following cases:
- When cicatricial narrowing of the pyloric sphincter (pyloric stenosis).
- When the pathology spreads beyond the stomach (penetration).
- When perforated (hole through).
- When an advanced form of an ulcer with large dimensions and a large depth of tissue damage.
In addition, stomach surgery may be prescribed if the patient has bleeding that cannot be controlled with medication. The reason for resection may be frequent relapses of the disease.
Resection for oncological neoplasms
Gastroenterologists and oncologists are often treated by patients with cancerous tumors. Gastric cancer is considered the most common form of cancer. Operationin case of gastric cancer, it may require not a partial resection, but a complete removal of the organ. This operation is called a gastrectomy. Formally, this is a type of resection, but the manipulation is more complicated, and the negative impact on the patient is more pronounced.
During gastrectomy, not only the stomach is removed, but also two omentums and lymph nodes. Complete removal of the stomach involves a direct connection of the esophagus to the jejunum. An artificial connection (anastomosis) is performed with a double-row intestinal suture.
After the operation, chemical and mechanical processing of food is not performed. This requires strict adherence to the diet and even distribution of meals throughout the day. Portions should be small, complex fats and hard-to-digest foods are completely excluded from the menu.
With a total gastrectomy, the laparoscopic method is almost never used. A traditional open technique is used in which a large incision is made. It takes several weeks for the patient to recover from the operation. After awakening from anesthesia, the patient does not drink or eat. He is put on a urinary catheter and a nasogastric tube, sometimes breathing through a mask.
Water is given to the patient only after the appearance of perist altic sounds. If the body reacts normally to the liquid, 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 the procedure is called sleeve removal. The operation cuts off most of the stomach, but savesphysiological 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 bag, it looks like a narrow tube, the volume of which is about 150 ml. There is a dramatic weight loss and a decrease in the feeling of hunger, since the zone that produces the hormone responsible for this feeling is removed. Longitudinal resection allows you to lose up to 60% of excess weight, while foreign objects such as a balloon or bandage are not placed in the stomach. This method of treating obesity can be used at any age.
Gastroenterostomy
For some indications, gastric resection is not possible. This applies to the elderly, weak patients, cases of cicatricial stenosis as a result of a stomach burn and inoperable cases of oncological diseases. These patients undergo gastroenterostomy. During the operation, an anastomosis is formed between the cavity of the stomach and the small intestine.
The operation helps to unload the stomach, speed up the evacuation of food and restore patency. However, it has so many complications that it is only performed when no other treatment options are available.
Vagotomy
Another way to treat stomach ulcers is vagotomy. This is an operation that involves cutting the vagus nerve. As a result of the manipulation, nerve impulses stop, on which the production of gastric juice depends. The acidity of the contents of the stomach decreases, as a result of which the healing of ulcers begins.
For the first time in the operating unit wasa patient was brought in 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 dropped dramatically as acid-blocking drugs have become widely used.
Operation cost
The cost of the same manipulation in different countries, and even in 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 resort to the help of surgeons. To cope with excess weight allows the operation of a longitudinal resection of the stomach. Its average cost in Russia is about 140,000 rubles.
