Gastrectomy is the removal of the stomach (usually in a block with its ligamentous apparatus, omentaries and regional lymph nodes). This is a high volume operation. After the stomach is removed, at the end of the operation, the surgeon stitches the remaining end of the esophagus to the mobilized segment or loop of the jejunum.
Gastrectomy cannot be performed with decompensated diseases of the cardiovascular system. Removal of the stomach is impossible if the patient has severe heart defects, unstable hemodynamics, in the acute phase of myocardial infarction, critical vascular stenosis of the heart and brain.
Immediately before the operation, it is necessary to take a blood and urine test, perform a gastroscopy with a biopsy, computed tomography and undergo other tests prescribed by doctors. Before gastrectomy, it is important for doctors to assess the prevalence of cancer and determine the volume of gastric removal.
At the EMC, all studies can be performed on an outpatient basis, in one day, without the need for hospitalization.
Laparoscopic and robotic access to surgical procedures is growing in popularity today. However, in the case of gastrectomy, it is safer and more effective to perform surgery and remove the stomach in an open way. The surgeon's experience and skills can reduce the risk of postoperative complications and diseases of the operated stomach.
After removal, the method of reconstructing the gastrointestinal tract is of no small importance for the function of the entire digestive system. Modern clinical practice is dominated by classical, so-called "loop" methods, in which the esophagus is connected to the jejunum loop, and the duodenum remains "turned off" from the passage of food. Such reconstruction options are accompanied in 30-40% of cases by so-called diseases of the operated stomach - pathological syndromes (for example, dumping syndrome, adductor loop syndrome, malabsorption syndrome, etc.), which significantly reduce the quality of life of operated patients.
This method provides a reservoir function of the jejunum segment moved to the stomach with restoration of the duodenal passage of food, which allows the patient to maintain a high quality of life and minimize the consequences of gastrectomy.
Her gastroplasty allows the patient not to change his diet in the future and return to his usual lifestyle 2-3 weeks after surgery. A person after a gastrectomy does not look exhausted, he does not have to follow a special diet. Surgical complications and pathological syndromes (so-called diseases of the operated stomach) are extremely rare in the long-term period after her gastroplasty.
At the EMC, gastrectomy is performed by Dmitry Valeryevich Ruchkin, MD, surgeon.
Karidakis surgery for epithelial coccygeal passage.
This is a radical method of surgical treatment: it involves an operation to remove the ECG with near-median access. The method was patented in 1976 by army surgeon G.E.Karydakis. During this method of cyst treatment, the surgeon makes an incision to remove the cyst not along the midline, but next to the intercostal fold. After such treatment, rehabilitation is faster, and the likelihood of recurrence of coccygeal passages is significantly reduced. Karidakis surgery has the only drawback – the asymmetry of the buttocks after removal of the coccygeal passages. In EMC, surgeons, performing such treatment, minimize this defect, find a way to make the suture less noticeable after surgical treatment of the coccygeal cyst. So, after cyst removal, the incision is sewn up with a complex layered multi-storey seam, which is then removed. This gives a very good result. In addition, modern electrosurgical equipment is used in the EMC, which makes it possible to operate on patients more efficiently and without severe blood loss and to remove coccygeal passages. All this has a positive effect on the outcome of surgical treatment, reduces the duration of rehabilitation and the likelihood of recurrence of inflammation.
At EMC, surgeons have extensive experience in performing nerve-sparing extirpations and have all modern technologies for dissecting (dissecting) the necessary tissues without damage. The surgeon has a Harmonic ultrasonic scalpel in his arsenal, which allows him to isolate tissue structures very subtly and accurately and not harm them. As a result of this approach, the patient will be able to avoid complications in the early postoperative period (urinary disorders, erectile dysfunction, pelvic organ dysfunction).
Among the surgical complications of gastrectomy, the most serious are anastomotic suture failure and intra-abdominal bleeding. EMC doctors have a manual technique for forming anastomoses: it reduces the risk of their failure by up to 2.5% after gastric removal surgery. At the EMC, the patient is monitored by doctors of various specialties at all stages of treatment.: they identify the risks of complications in a timely manner and prevent them.
In addition, her gastroplasty reduces the risk of dumping syndrome. This is a complication in which the ingested food quickly enters the small intestine and irritates its mucous membrane with the development of a number of pathological reactions. Recall that in a healthy person, food is thoroughly digested in the stomach and only then enters the small intestine. Dumping syndrome causes excessive blood filling of the small intestine with partial depletion of blood flow in other organs - the heart, kidneys, and brain. In addition, there is a sharp fluctuation in blood sugar levels – first an increase, then a sharp decrease. The patient's heart rate increases, cold sweat appears, the skin turns pale, tremors appear, and blood pressure decreases.
With timely combined treatment of gastric cancer, including radical surgical treatment (subtotal gastric resection or gastrectomy) and systemic polychemotherapy, a favorable prognosis of long-term survival is achieved.
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