Gastrectomy is the surgical removal of all or part of the stomach, performed for both oncologic and benign indications. Total gastrectomy excises the entire stomach with reconstruction by esophagojejunal anastomosis, while subtotal or partial procedures remove a portion and preserve gastric remnant continuity; sleev…
Gastrectomy is the surgical removal of all or part of the stomach, performed for both oncologic and benign indications. Total gastrectomy excises the entire stomach with reconstruction by esophagojejunal anastomosis, while subtotal or partial procedures remove a portion and preserve gastric remnant continuity; sleeve gastrectomy resects the greater curvature to create a tubular stomach. The principal indication is gastric malignancy, including adenocarcinoma and rarer tumors such as adenosquamous carcinoma and Epstein–Barr virus–associated gastric carcinoma, where resection with adequate margins and lymphadenectomy is central to potentially curative treatment. Other indications include refractory ulcer disease, certain inflammatory conditions such as granulomatous gastritis, and, in the sleeve form, the surgical management of severe obesity. Because the stomach mediates reservoir function, mechanical digestion, acid and intrinsic factor secretion, and the regulation of intake, its removal alters gastrointestinal physiology and predisposes to nutritional consequences. These include deficiencies of iron, calcium, folate, and vitamin B12, with the risk of thiamine deficiency and Wernicke encephalopathy after restrictive or malabsorptive procedures, as well as dumping syndrome and altered glycemic control. Outcomes depend on the extent of resection, reconstruction technique, and adjuvant oncologic therapy, and long-term care emphasizes lifelong nutritional surveillance and supplementation to offset reduced absorptive and digestive capacity following the operation.
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