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Gastroenterology (Expert Forum)

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Total Gastrectomy

Answered by

Kevin Pho, MD - Internal Medicine

Kevin, M.D. Boston - MA

This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/Diverticulosis, Digestive Disorders, IBS, Stomach Pain.

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MedHelp Member's Question

Total Gastrectomy

by ccblues03, Jan 23, 2004 12:00AM

Tags: gastrectomy, Cancer, nutrition, surgical, Stomach Cancer, feeding tube

My father had a total gastrectomy after diagnosis of stomach cancer. Then immediately engaged in intense chemo and radiation therapy. He's not been able to hold down food at all and has lost weight to the point of needing hospitalization. There's a problem with bile production and there may be some kind of obstruction, infection or other condition in his esophogus where he simply cannot eat or drink anything whatsoever. Constantly spitting up, burping, etc. Needless to say, he's severely underweight, has no energy at all and although the docs seem to be trying everything...nothing is working. His only nutrition right now is via TPN. Nobody knows if the chemo contributes to the condition. My question is simply this...if it can be established that a partial stomach would solve the problem; is it possible to remove a partial section of the stomach from a family donor and transplant or construct a partial stomach for the patient? I can find nothing regarding this on the 'net.

Thanks

Doctor's Answer

by Kevin Pho, MD

, Jan 25, 2004 12:00AM

As surgeon has mentioned below, I am not aware of the procedure you are suggesting being possible.  The suggestion of placement of a feedng tube is a good one.  The chemotherapy may have complicated the anatomy, causing the symptoms.

Increasing caloric intake and improving nutrition would help with the healing process.

I would consider a GI and nutrion referral to consider the need of a feeding tube.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Thanks,

Kevin, M.D.

Member Comments (4)

by surgeon, Jan 23, 2004 12:00AM

that's not something that's done. One solution that may be better than tpn is to have a feeding tube inserted into the intestine, which would mean another -- but relatively minor -- operation. The body does better with calories that come in through the gut than those that come via the IV. I'd assume the anatomy of the hookup has been reviewed to look for obstructions; it might or might not evenually need surgical revision. But having radiation to the area complictes things, both in terms of delaying recovery, and interms of options for reoperation. For now, given what you describe, I'd consider surgical placement of an intestinal feeding tube. If one had been placed during the original operation, as they often are, it may be possible to reinsert it using xray guidance without an open reoperation. Getting better nutrition will improve the chances of recovery without major surgical intervention.

by kevinmd, Jan 26, 2004 12:00AM

Sorry - I meant to say "nutrition" referral. Sorry for the typo.

Thanks,

Kevin, M.D.

by gramag, Jan 29, 2004 12:00AM

I don't know what a TPN is, butI had a feeding tube put in the jejunum but still lost 50 lbs. I know, for me, it was absolutely necessary.

by JackieG, Jan 29, 2004 12:00AM

To: ccblues03

The tube that surgeon and ging refer to is a "J" tube, and will enable your father to get better nutrition than an IV. I am very surprised that he doesn't already have one, given the need for re-hospitalization due to malnutrition. You should discuss with his docs, but there may be a reason that they have ruled out a J tube.

There are Internet-based support groups for gastric cancer that are excellent sources of both support and information, and are helpful for the patientt, caregivers, and the patient's family. Try ACOR's home page at www.acor.org. You will be able to join a gastric cancer support group with hunderds of subscribers. There is no cost. You and your father may find that you benefit from the first-hand experiences of other folks who have already travelled the path you are on now.

My thoughts are with you and your father.

Best regards,

Chicken Soup

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