Total Gastrectomy – Stomach Cancer

In total gastrectomy, where the entire stomach is removed, the remaining open oesophagus, or stump, is joined to the first part of the jejunum (small intestine) to facilitate the passage of food. This surgery is called Roux-en-Y.

Total gastrectomy is indicated in patients with cancer in the lower part of the oesophagus.

The stomach must be completely removed due to the particular way that lymphatic fluid is drained in the anatomical area of the stomach.

When the cancer site is on the cardioesophageal junction, a particular classification, according to the Siewert I, II or III system, should be made.

This categorization can completely change the plan and strategy of the operation, so that instead of total gastrectomy, the Ivor Lewis -type oesophagogastrectomy approach can be adopted.

The operation is usually combined with preoperative (neoadjuvant) chemotherapy, as well as supplementary (adjuvant) chemotherapy.