Nutrition after complete removal of the stomach in cancer. gastrectomy

Gastrectomy is a surgical intervention aimed at removing a fragment of the stomach or the entire organ. This operation is performed in the presence of neoplasms, both benign and cancerous. As a result of its implementation, substances enter the intestine in a poorly processed form.

Consequently, the body does not receive enough vitamins and minerals. This article describes the principles of nutrition after removal of the stomach, which help prevent complications.

About pathology

Malignant formations in the gastrointestinal tract occur, among other things, due to emotional overload, alcohol abuse and harmful products.

One of the serious ailments of this kind is a tumor of the stomach. The disease contributes to the death of mucosal cells. Pathology requires surgical intervention. The operation must be carried out as quickly as possible.

This medical measure consists in removing a fragment of an organ and lymph glands in which an inflammatory process has developed. This procedure is necessary in order to prevent the growth of the tumor. If the pathology is detected at a later stage, a radical gastrectomy is performed.

This surgery involves the removal of the entire organ. The operation has an extremely negative effect on the patient's condition. Some patients die as a result of its complications.

However, even if the surgical intervention was not radical, a person will need quite a lot of time to recover. To normalize blood circulation, doctors install catheters.

Within a week after this event, the patient experiences discomfort, so he is prescribed analgesics. At first, the human body is not able to absorb the usual foods and volumes of food. Therefore, you should eat in small portions, five to six times a day. It is also necessary to strictly adhere to the diet. Proper nutrition after removal of the stomach helps the patient to recover quickly and improve their well-being.

What complications occur as a result of gastrectomy?

The consequence of resection are violations of the activity of the digestive tract. The absence of an organ fragment leads to the fact that food moves faster through the digestive tract. Because of this, patients experience a feeling of heaviness in the abdomen.

In addition, many patients notice dizziness, increased drowsiness, a feeling of weakness, and profuse sweating. Some people experience loss of consciousness, anemia, weight loss. All these symptoms are explained by metabolic disorders and intestinal activity, vitamin deficiency. To avoid such phenomena, or at least minimize them, you should follow the rules of nutrition after removal. Patients need to follow a diet for six months.

Basic principles of the diet

What should be the food? First of all, you need to remember the following recommendations:

The diet should include a sufficient amount of proteins and complex carbohydrates.
Fats should be limited, and foods fried in oil should be excluded.
Dishes containing sugar are also prohibited. You can not use sweets, cakes, carbonated drinks and juices in packages.
You should refuse food that contributes to the separation of bile and increase the activity of the pancreas.
It is necessary to limit the amount of salt consumed to 5 grams per day.
Alcohol-containing products, black coffee, strong brewed tea and cocoa are prohibited.
Foods that contain starch (bananas, potatoes, legumes) should be kept to a minimum.
Eat in small portions, at least five times a day.
Replenish the balance of fluid in the body with freshly squeezed juices without salt and sugar, weak green tea, clean water.

It must be remembered that light, but nutritious meals containing enough fiber and vitamins will help a person quickly bounce back.

If the patient is concerned about unpleasant symptoms after resection, he needs to consult a specialist about therapy.

The diet of the patient on the first day

First, a person is assigned complete fasting. He must abstain from food and liquids for two days. On the third day, you can use small portions of a decoction made from rose hips, weak tea, unsweetened compote without fruits and berries. However, such drinks are allowed only in the absence of stagnation in the digestive tract.

2-3 days after the gastrectomy, a special mixture containing proteins, vitamins and minerals is administered to the patient using a probe. What kind of food after removal of the stomach does a person need for 4-5 days? Recommendations for the preparation of the diet are given taking into account such factors as the stage of development of the pathology, the age category of the patient, his physical well-being and psychological state.

You should also gradually increase the load on the digestive tract, so as not to provoke violations.

Another diet should include foods that prevent the appearance of tumors. Nutrition after removal of the stomach for cancer involves the use of a sufficient amount of fruits and vegetables, as well as the exclusion of food containing carcinogens.

The diet of the patient for 4-5 days

During this period of time, the diet can already be slightly diversified. It is necessary to use products in a wiped form.

The diet includes first courses, souffles made from fish, meat and cottage cheese, soft-boiled eggs. Then you can add liquid cereals, steamed omelettes, a little mashed vegetables to the diet.

To remove the stomach for 5-10 days, it involves a gradual increase in the volume of products from 50 to 400 milliliters. With a properly organized diet, a person receives all the necessary substances for recovery, but does not overload the digestive tract.

What foods should be excluded?

After about 9-12 days, more protein-rich foods should be introduced into the diet. They should be stewed, boiled or steamed. Fish and meat are best served chopped.

Proper nutrition after removal of the stomach in oncology contains a minimum amount of fast carbohydrates and lipids. To avoid complications, the following types of food are excluded:

Strong meat and fish broths.
Fresh bread, flour products.
Sausages, and smoked products.
Meat, fish and poultry with a lot of fat.
Dishes from barley, corn, millet and pearl barley.
Pasta products.
Mushroom dishes.
Raw vegetables: cabbage, radish, radish, onion.
Bean plants.
Fatty dairy products.
Salty and fried foods.
Spices and hot condiments.
Black coffee and strong brewed tea.
Dishes with chocolate and cocoa powder.
Alcohol-containing products.
Juices from packages, sparkling water.
Sour fruits and fruits.
Sweets and cakes.
Jam, condensed milk, ice cream and cakes.

What foods are allowed?

The food menu after removal of the stomach includes the following dishes:

Oatmeal porridge cooked with water or low-fat milk.
Biscuits are biscuit.
Cottage cheese (rice) casseroles.
Jelly fruit or berry.
Soufflé, fruit mousses.
Stewed vegetable ragout.
Compotes.
The first dishes of pumpkin, beets, zucchini, carrots in pureed form.
Baked fruits.
Meat dishes in chopped form, steamed (soufflé, meatballs).
Buckwheat groats boiled.
Crushed potatoes. You can add to it a mild sauce based on low-fat sour cream.
Steamed cottage cheese.

Sample Menu

The daily diet after removal of the stomach is approximately as follows:

In the morning you need to drink a glass of non-carbonated mineral water with a little lemon juice. This liquid helps to normalize the metabolic process.
After a while, you can eat some vegetables or fruits with half a cup of kefir.
For lunch, it is recommended to use a pureed first course, salad and boiled meat.
For an afternoon snack, eat steamed curds. Wash them down with natural juice.
Dinner consists of stewed vegetables, boiled poultry or fish, a small amount of rice porridge.

The compilation of the stomach for cancer and the menu is done by a specialist who monitors the patient's condition for a long time.

Features of the further diet

After six months, you can introduce a few more products:

Fresh curd.
Sour-milk drinks (kefir, yogurt, varenets).
Sausage and ham (diet varieties).
Jellied fish, soaked herring.
Boiled beef tongue.
Coffee with milk.
Butter (it is added to dishes).
Crackers, toast, dough products (except for butter).
Small portions of desserts: jam, marshmallows, marshmallows, marmalade.

Nutrition after removal of polyps in the stomach

Sometimes benign tumors are formed in the tissues of the mucous membrane of the organ. They are not accompanied by severe symptoms and are detected during EGD. These growths are called polyps.

The disease can only be cured by surgery. Adhering to a diet in this case is just as important as following the rules of nutrition after removing the stomach.

To recover quickly, the patient should give up fried, spicy, salty and smoked foods. Exclude products from flour, milk, cabbage and legumes. Under the ban alcohol, juices in packages, coffee, soda.

The diet after the removal of polyps includes mashed soups, cereal dishes, lean meat and steamed fish, toast, crackers. From drinks, a decoction of rosehip berries, compote, clean water is allowed. If the patient has no complications and his condition has stabilized, you can expand the diet.

Dairy products with a low percentage of fat content, vegetables and fruits, weakly brewed tea, salads with vegetable fat, red varieties of fish are added to the diet. Compliance with the principles of proper nutrition helps to minimize the risk of complications and the recurrence of pathology.

Modern ecology and the way of life of many people who prefer unhealthy snacks to full-fledged food from natural products are the causes of gastrointestinal diseases. With untimely detection, late stages of pathologies require surgical treatment. Most often, surgery is used to eliminate stomach cancer. There are several types of operations, selected according to the degree of damage and the spread of the pathological process in the stomach and beyond. The classic operation lasts from 2 to 4 hours.

Indications and contraindications

The main reason for the appointment of operations is a cancerous lesion of gastric tissues. Removal of part of the stomach or the entire organ with lymph nodes allows you to cut out the bulk of the cancer cells, which reduces the risk of recurrence. To consolidate the effect, adherence to postoperative recommendations, such as diet, radiation and chemotherapy, is required. Surgery for stomach cancer is prohibited when:

there are metastases in separated organs, such as the liver, ovaries (in women), peritoneal pocket, lungs, supraclavicular and separated lymph nodes;
there is a large accumulation of free fluid in the organs and abdominal space (ascites);
the body is severely depleted, there is a large weight loss with general weakness (cancerous cachexia);
diagnosed with cancerous peritonitis, suggesting the spread of pathological cells throughout the peritoneum;
there are diseases of the heart, blood vessels, kidneys;
diagnosed with a hereditary bleeding disorder (hemophilia).

In the absence of contraindications, surgery for stomach cancer is performed regardless of the age group. It is possible to prescribe radiation and chemical therapy, as a result of which the tumor shrinks, which increases the efficiency of its removal.

Types of operations for stomach cancer

The choice of the type of gastric surgery due to the removal of a malignant tumor is based on several criteria:

location of the tumor;
degree of metastasis;
the number of metastases;
patient's age;
results of preoperative diagnostics.

Operation types:

Resection or partial removal of tissue with a tumor.
Gastrectomy involves the complete removal of the stomach for cancer. Additionally, parts of the intestine or esophagus may be cut off.
Lymph node dissection is characterized by cutting off the fatty layer, lymph nodes, blood vessels.
Palliative surgery is used to alleviate the general condition and course of cancer in cases where the cancer is not operable. After applying the technique, patients live longer.

The prognosis and survival after any operation depends on the extent of the cancer and its prevalence.

How is a resection done?

During the operation, either part of the organ or the entire organ is removed, depending on the lesion.

The method involves the complete removal of an organ or cutting off part of it. There are several techniques. Total excision or gastrectomy is used when:

the primary focus of cancer cells is located in the middle part of the stomach;
if all parts of the body are affected.

Excised together with the stomach:

affected areas of the peritoneal fold holding the organ;
full or partial pancreas;
spleen;
nearby lymph nodes.

After excision of the stomach, an anastomosis is performed, that is, the connection of the upper intestine with the 12 duodenal process and the esophagus for the supply of digestive enzymes. The method belongs to heavy operations. Survival, disappearance of gastric cancer after surgery or not, how well the restoration of digestive function and recovery of a person, depend on the accuracy of following the postoperative diet.

Selective proximal resection is used when the tumor is located in the upper half of the stomach. It is prescribed in rare cases and with the following characteristics of the neoplasm:

size - less than 40 mm;
exophytic growth, that is, on the surface of the wall;
clear boundaries;
without damage to the serosa.

During resection, the upper affected area, 50 mm of the esophagus, and neighboring lymph nodes are cut off. A canal is formed that connects the esophagus to the operated stomach. Distal resection is prescribed for cancer in the lower region of the stomach. Simultaneously with the organ, the lymph nodes, parts of the duodenal process of the intestine are cut off. A gastroenteroanastomosis is formed to connect the organ stump with the small bowel loop.

Gastrectomy

The operation is classified as a laparoscopic technique, which involves minimally invasive intervention. Produced in the following order:

A small incision is made in the abdominal wall.
An endoscope with a camera is inserted into the hole to examine the stomach and adjacent structures.
Additional incisions are made.
The surgical instrument is inserted.
The affected tissues are excised.
The remaining parts are sutured.

Removal of the stomach in gastric cancer by the laparoscopic method is performed in full or in part using a special surgical knife. To improve visibility, carbon dioxide is injected into the abdominal cavity. The camera located on the endoscope transmits the image to the monitor, on which the surgeon can select the area to enlarge the image. This allows you to see the pathology and perform excision with high accuracy. The main advantages of laparoscopic gastrectomy:

the minimum number of postoperative complications;
facilitated rehabilitation period.

Removal with lymph node dissection

The method refers to additional measures that involve cutting off nearby lymph nodes, choroid plexuses and adipose tissue. The volume of lymph node dissection depends on the degree of malignancy. There are several types of such operations:

Reduction of adipose tissue with preservation of lymph nodes.
Cutting off nearby nodes to the large and small omentum.
Excision of nodes in the midline from the affected organ.
Additional removal of structures at the celiac trunk.
Cut off nodes around the aorta.
Removal of all lymph nodes and cancerous organs near the stomach.

Lymph node dissection is difficult to perform, but the risk of recurrence is much less.

Palliative surgery for stomach cancer includes operations that temporarily alleviate the condition of patients.

Effects of applying the method:

relief of symptoms;
a decrease in the size of education;
reducing the risk of intoxication;
increasing the effectiveness of radiation and chemotherapy.

There are two types of palliative surgery:

A method that allows you to create a bypass channel to the small intestine. The affected organ can be removed without affecting the lymph nodes and nearby tissues. Effects:
- improving the quality of nutrition;
- relief of the general condition;
- improved tolerability of further treatment.
Complete removal of the tumor. The postoperative effect is an increase in the effectiveness of radiotherapy and chemotherapy.

Palliative care prolongs the lives of people with terminal cancer. The method is contraindicated when the mesentery, brain and bone marrow, lungs, peritoneal sheets are involved in the oncological process.

Preparing for the operation

Preoperative preparation is needed to improve the psychological state, the work of the body as a whole:

Before the provision of surgical intervention, it is necessary to adhere to a special diet.

A special diet consisting of pureed, liquid, easily digestible food. Meals should contain the whole complex of vitamins.
Psychological preparation. Usually people are not told about cancer. Before the operation, a progressive gastric ulcer is reported, which must be urgently operated on.
Positive attitude of the patient. This requires the support of relatives.
Medical preparation involves taking:
- multivitamins;
- means that increase the functionality of the gastrointestinal tract;
- sedatives to improve sleep quality and psychological well-being;
- proteins and plasma to eliminate anemia;
- drugs that improve the functioning of the liver, kidneys, heart;
- antibiotics to stop inflammation and reduce temperature;
- hemostatic (if necessary).
Gastric lavage. Furacilin solution, potassium permanganate, hydrochloric acid are used. This must be done to completely empty the gastrointestinal tract.
Chemotherapy to reduce the size of the tumor formation and stop metastasis.

Having diagnosed a person with an oncological disease of the tissues of the stomach, which has a malignant nature of origin, doctors first try to help the patient with the help of chemotherapy drugs. If the pathology is in a too neglected state or the use of medications has not brought the expected effect, then in this case, the doctors decide on a radical method of ridding the patient of the tumor, which consists in performing a surgical operation. Its implementation involves the complete or partial removal of the most important organ of the digestive system, so that cancer cells do not spread to healthy tissues located in close proximity to the tumor body. This allows not only to significantly extend the life of the patient, but also to completely recover from cancer.

Of course, a person cannot live completely without an organ for the primary digestion of food. He will be forced to depend all his life only on intravenous drips and injections, with the help of which vitamins, minerals and other nutrients enter his body. Therefore, surgeons who are forced to completely remove the patient's stomach divide the surgical treatment into several stages. At the first stage of gastrectomy, the organ is cut off, since the tumor has affected all its departments and it is no longer suitable for ensuring the stable life of the organism as a whole.

In parallel with this, another team of surgeons immediately proceeds to the formation of an intermediate section of digestion, which will serve as a prototype of the stomach. It is sewn from the loop-shaped tissues of the intestine. Of course, it will not be able to perform the full range of functions for digesting food, it will not synthesize hydrochloric acid, grinding coarse food particles, but it will be able to improve the process of assimilation of nutrients that will enter the intestine already prepared. This kind of operation requires large material costs and jewelry work from doctors, but this is the only way to prolong the life of patients with stage 4 stomach cancer.

How long do people live after removal of the stomach for cancer?

Life without a stomach is a set of peculiar rules that must be followed daily. Especially if not a partial, but a complete resection was performed. It is believed that the highest probability of the recurrence of the disease in the form of a relapse is the first 5 years after the operation. If during this time there was no re-formation of tumor bodies in neighboring organs, the esophagus or other parts of the digestive system, then in this case, you can count on a complete elimination of cancer.

Such a person can live to a ripe old age and die from completely different pathologies.

If it so happened that the removal of the stomach in case of cancer generally went well, the patient recovered quickly and there were no significant complications, but in the next 5-year period, cancer cells were re-detected in the blood, then the further life span in rare cases exceeds 10 years. frontier. Often a person is diagnosed with new oncological formations of malignant etiology, which grow even faster than the previous tumor. In addition, the patient's body becomes very weakened, since gaining weight after removing the stomach is not an easy task, and most of the nutrients are simply not absorbed by the digestive system.

How to eat after stomach surgery for oncology?

Like any other rehabilitation period, gastrectomy provides for a categorical ban on the use of a certain type of food, while other types of products, on the contrary, are allowed to be taken.

What can you eat?

Despite the fact that the resection of the most important digestive organ was performed, nutrition after gastric surgery should still be varied and useful at the same time. In this regard, the patient is prescribed the following types of products and dishes based on them:

puree soups, to which porridges from oatmeal, buckwheat, wheat, rice groats, previously ground in a blender, were added;
lean fish (pollock, herring, hake, tuna, sardine, cod, pike);
soft-boiled eggs or scrambled eggs;
if there is no individual intolerance, then it is allowed to include small portions of cottage cheese, kefir, fermented baked milk, sour cream, hard cheese in the diet;
kissels cooked on the basis of fresh berries;
compotes from dried fruits, wild rose.

Eating should consist of small portions so as not to overload the already depleted digestive system.

The nutrition menu after gastric resection for cancer is formed with the participation of a surgeon, who is the attending doctor of the patient.

What can't be eaten?

To avoid attacks of acute pain in the abdominal cavity and other postoperative complications, the following types of food should be completely excluded from the diet of a cancer patient:

strong meat broths, which contain an increased concentration of gelatinous substances in their composition and can create an undesirable burden on the digestive system;
confectionery and flour products prepared using yeast cultures;
sausages, canned food and other dishes that are secondary processing of meat;
dishes obtained as a result of frying in a pan with the addition of vegetable oil;
all kinds of pickled foods and various kinds of pickles;
raw vegetables and fruits (especially cabbage, turnips, carrots, onions, radishes, all kinds of legumes);
carbonated drinks, juices, coffee and tea, alcohol;
all varieties of tomato sauces, seasonings and spices;
mushrooms (regardless of how they were cooked).

Compliance with this diet and the exclusion of the above products from your diet will significantly speed up the process of complete recovery. The patient will feel much better, quickly return to his usual way of life, and restore his ability to work.

Rehabilitation and recovery

The rehabilitation process begins immediately after the completion of the operation. In fact, from the first day after the gastrectomy was performed. The main direction in the recovery technique is to provide a person with high-quality dietary nutrition. In general, for a complete recovery, the patient is recommended to perform the following actions:

do not drink alcohol, completely stop smoking;
eat only those foods that are allowed by the attending physician and in no case violate the established diet;
walk daily in the fresh air to strengthen the immune system, which fights the remnants of cancer cells;
avoid stressful situations and nervous strain;
sleep at least 8 hours a day;
go to the toilet daily, avoid constipation lasting longer than 1 day;
eat small portions, which consist of 200-300 grams of food at a time (it is better to provide yourself with more frequent approaches to the table, but do not overeat);
do not lift things and objects whose total weight is more than 3 kilograms;
regularly visit a surgeon, oncologist, gastroenterologist in order to monitor the process of the digestive system organs and prevent possible complications in a timely manner.

The average duration of the rehabilitation period after surgery for complete or partial removal of the stomach is 1-2 years. At this time, a person should provide himself with exceptional peace and seriously take care of his health. Otherwise, it can expect poor healing of surgical sutures and a relapse of the disease.

One of the key organs of the gastrointestinal tract is the stomach, in which:

mechanical and chemical digestion of the food coma entering through the oral cavity and esophagus,
the production of hormonal substances and special enzymes for the absorption of sugar, salts, vitamins and water,
providing protection against various pathogenic bacteria.

Surgical removal of the stomach, as one of the methods of its treatment, is carried out only in extreme cases.

The indication for total gastrectomy or partial resection of this organ may be the development of such serious pathologies as precancerous or benign polyps, wall perforation, peptic ulcer or cancer.

Indications for surgical treatment of the stomach

Partial gastrectomy, which involves removing part of the stomach and connecting one half or upper third of it to the duodenum or small intestine, is usually done if you have:

Polypov;
Peptic ulcers of the duodenum and stomach of neglected forms, as well as those complicated by perforation of the wall or bleeding;
Benign or malignant neoplasms;
Pathological structure of the pylorus;
gastric stenosis;
Overweight patient.

A total gastrectomy is an operation in which the entire stomach is removed and the esophago-intestinal anastomosis is superimposed.

It is performed only in extreme cases, when the use of other methods of treatment is meaningless due to their inefficiency, including:

stomach cancer;
Zollinger-Ellison syndrome.

Preparing for the operation

Preparation for gastrectomy consists, as a rule, of the following procedures:

Medical examination of the patient and his questioning;
Submission of laboratory tests of urine and blood, including:
- general and biochemical analyzes;
- blood clotting test;
- tumor markers;
Examination of the organs of the gastrointestinal tract with the help of:
- radiography;
- computer and magnetic resonance imaging;
- fibrogastroduodenoscopy with biopsy;
Carrying out an ECG;
Anesthesiologist consultation;
The passage of radiation and chemotherapy to stop the growth of both the tumor itself and metastases when diagnosed with cancer.

A week before surgery, the patient should stop smoking and stop taking vitamin E and drugs that thin the blood and have anti-inflammatory and antiplatelet effects. The day before the operation, the patient is recommended only light food, eating and drinking on the day of the operation is contraindicated.

Performing a gastrectomy

The operation to remove the stomach lasts an average of two to five hours and is performed under general anesthesia in several stages, including:

Intravenous administration of anesthesia;
Treatment with an antiseptic solution and opening the abdominal cavity with a wall incision from the chest to the navel zone;
Removal:
- stomach;
- abdominal lymph nodes;
- large and small glands;
- existing neoplasms in the esophagus;
The intersection of the nerves and arteries suitable for the stomach;
Cut-off from the stomach and suturing of the duodenum;
Moving and crossing the distal part of the esophagus;
Formation and imposition of a connection, or anastomosis, between parts of the esophagus and small intestine;
Suturing of the abdominal wall.

If the patient has a large number of metastases in other organs, total gastrectomy is not performed.

In addition, the removal of the stomach has a number of relative contraindications, including:

severe respiratory and heart failure;
hemophilia;
kidney failure.

Possible Complications

After a gastrectomy, a patient may experience and develop complications such as:

Anemia;
Peritonitis;
Bleeding;
Reflux esophagitis;
dumping syndrome;
Cancer of the stomach stump.

These complications may occur after operations on other organs of the digestive system, to exclude them, it is necessary to strictly follow all the recommendations of the attending physician.

Nutrition after gastrectomy

After removal of the stomach, the patient's diet undergoes significant changes. Due to the fact that the organ for storing and digesting food is now absent, it must be supplied in small portions at least eight times a day. Adding products is not recommended.

In addition, the diet involves the exclusion from the diet:

pickled, smoked, fried, fatty and spicy dishes;
raw vegetables;
porridge with milk;
jam, sugar and honey;
rich broths.

The menu at the same time should include foods rich in vitamins and useful trace elements. Food should be tasty, varied and complete. It can be vegetables, meat and fish of low-fat varieties.

Food is recommended to be steamed or boiled without adding any spices. Too cold or hot foods and drinks should be discarded, while warm coffee or tea can be drunk only half an hour after a meal in a volume not exceeding 200 ml.

At this time, the patient should pay special attention to the importance of slow food intake, accompanied by its thorough chewing, the obligatory and systematic intake of hydrochloric acid solutions.

Life after surgery

The operation to remove the stomach does not deprive the patients of a full-fledged, joyful life in the future. After gastrectomy, as after any surgical treatment, there is a rehabilitation of patients, lasting at least three months.

At this time, daily bowel movements and adherence to a special hyposodium diet are mandatory, which involves:

Increased intake of vitamins and proteins;
Reducing the intake of salt, carbohydrates and fats;
Limitation of such chemical and mechanical irritants of the mucous membrane of the digestive tract, such as:
- alcohol;
- spices;
- o chocolate;
- o canned food;
- o carbonated drinks;
- o various smoked, marinades and pickles.

For a quick recovery after surgery, doctors recommend that patients move more, which will contribute to intensive stimulation of the whole body.

Survival prognosis

The duration and quality of life after gastrectomy directly depend on factors such as:

the reason for the operation;
the stage of the disease and the presence of metastases in the case of stomach cancer;
age;
the general medical condition of the patient.

If a neoplasm is detected at an early stage of its development and timely surgical intervention is performed, the five-year survival rate of the patient is about 90%, and his life expectancy is several decades. If the tumor is diagnosed in a neglected state, has a large size and numerous metastases that go to the lymph nodes and nearby organs, the prognosis for the patient is not optimistic.

Surrounding close people are called upon to help the patient survive a difficult period in his life and prevent the development of possible complications. The optimal method of influence in this case is a friendly conversation with him with an explanation of the need for precise implementation of the doctor's recommendations, constant care and attention.

People who are faced with the removal of the stomach and have lost the natural possibility of chemical and mechanical processing of food in the stomach must adapt to completely different anatomical and physiological principles of digestion. By following the doctor's recommendations on diet and lifestyle, you can live without a stomach in almost the same rhythm.

When is the operation performed

The operation of complete removal of the stomach or gastrectomy is severe and traumatic. Often this is an extreme measure, resorted to if it is known that conservative treatment will not be able to save the patient.

During the operation of removing the stomach, the entire esophagus is connected directly to the duodenum 12.

The reason for such an operation is most often a malignant tumor.
Much less often, gastrectomy is performed for a benign tumor, for example, multiple mucosal polyposis, perforation of the stomach wall, or peptic ulcer with bleeding.

If the reason for the operation was a malignant tumor, an extended gastrectomy is performed, that is, simultaneously with the complete removal of the stomach, the omentums, spleen and regional lymph nodes are excised.

Adaptation of patients after gastrectomy

Rehabilitation and adaptation to new nutritional conditions lasts about a year. During this period, complications are possible:

Reflux esophagitis. Inflammation of the esophageal mucosa due to the reflux of intestinal contents and bile from the small intestine.
dumping syndrome. It occurs as a result of unprocessed food entering the intestine and is accompanied by vegetative crises - dizziness, sweating, weakness, palpitations, sometimes a single vomiting occurs after eating.
anemic syndrome.
Rapid weight loss.
Hypovitaminosis - most vitamins are absorbed in the stomach. In its absence, the necessary compounds are not absorbed. Correction - parenteral administration of multivitamin complexes.

These concomitant symptoms are noted by all patients, communicating on the forum and sharing their experience of how they live after the removal of the stomach.

Features of nutrition and diet

Diet therapy in the postoperative period is the main component of rehabilitation.

The main task of the diet:

create peace for wound healing at the junction of the esophagus and duodenum 12;
provide the body with essential food ingredients;
prevent bloating.

Immediately after the operation in a hospital, the patient is prescribed hunger on the first day. For nutrition, the parenteral method is used, that is, intravenous administration:

saline solutions (Trisol, Disol);
amino acids (Aminoplasmal);
glucose;
specialized mixtures (Kabiven).

If the postoperative period passes without complications, from the third day you can give not very sweet compote or rosehip broth in the amount of 250 ml during the day. Drinking is often given in a teaspoonful.

With a satisfactory condition of the patient, they sequentially switch to surgical diets:

on day 4-5, a 0A diet is allowed;
on day 6-8 - diet 0B;
on days 9-11 - diet 0B.

When switching from one surgical diet to another, the calorie content of dishes is gradually increased and new products are added. At first, everything should be served only liquid, then gradually move on to mashed and pureed dishes.

The duration of each table of the surgical diet usually lasts from 2 to 4 days, if necessary, it can be adjusted.

In the future, the menu is supplemented with easily digestible products containing a sufficient number of necessary components:

primarily proteins, fats, carbohydrates;
as well as vitamins, mineral elements and a large volume of liquid.

With proper functioning of the intestines, from the 14-15th day, the patient is transferred to table No. 1 according to Pevzner.

If the patient feels normal, after 3-4 months they are transferred to the unrubbed version of diet No. 1 according to Pevzner. This is already a completely complete physiological diet with a high content of proteins and a slightly reduced amount of carbohydrates and fats.

The main task of diet therapy for patients after gastrectomy is to replenish the protein and mineral-vitamin deficiency that has formed after surgery. Therefore, already on the 4-5th day, the diet begins to be enriched with protein products with a quick transition to a full-fledged diet with a full range of nutritious ingredients.

Culinary processing of products remains the same - this is boiling, steaming, stewing. Preference is given to protein-rich foods. The menu may consist of:

from low-fat broths;
mashed vegetable soups based on cereal broths;
lean beef, chicken or fish dishes;
it is allowed to serve pike perch, cod, hake, carp;
you can cook steam omelettes or soft-boiled eggs;
if the patient tolerates milk well, milk soups, cereals are included in the diet;
as seasonings, you can use vegetable oils, as well as butter;
fruits are used to make kissels, jelly, mousses;
bread can be eaten dried, a month after the operation;
from this period, you can diversify the menu with fruit juices, unsweetened tea;
A month later, you can start giving kefir.

The volume and assortment of dishes should expand gradually.

In order to prevent the occurrence of dumping syndrome, easily digestible carbohydrates - sugar, jam, honey and other sweets - are excluded from the menu.

After surgery, you should completely exclude from the diet:

any kind of canned food;
fatty foods and products;
pickled vegetables and pickles;
smoked meats and fried foods;
muffin;
ice cream, chocolate;
spicy seasonings;
drinks containing gas, alcohol, strong tea and coffee.

During this difficult period, it is necessary to limit physical activity and strictly follow the recommendations of the attending physician.

How long do they live after stomach removal

Now medicine has moved forward, the methods of examination and the approach to treatment have changed, this affects the increase in life expectancy after the complete removal of the stomach.

If the operation was performed for a malignant tumor, only the attending physician can answer this question, it all depends:

from the stage of the process;
patient's age;
concomitant diseases;
immunity;
discipline;
psychological state of the patient.

On the forum, patients often discuss life after removal of the stomach for oncology. Many people talk about fairly long life after surgery, especially if gastrectomy was performed in the early stages. According to statistics, the five-year survival rate in this case approaches 90%.

If the patient is operated on for another reason, the prognosis is usually favorable. Of great importance in this case is the clear and consistent implementation of medical recommendations.

After the end of the rehabilitation period, patients return to an almost normal lifestyle, with the exception of some dietary restrictions. It does not affect life expectancy.

To prevent unwanted possible consequences and complications after surgery, it is necessary:

limit physical activity to a minimum for several months;
wear a postoperative bandage;
eat only permitted foods, following all dietary recommendations;
take vitamin and mineral supplements prescribed by your doctor;
if necessary, take hydrochloric acid and enzyme preparations to improve digestion;
for timely detection of complications, undergo regular examinations.

Prevention of dangerous diseases that can lead to the complete removal of the stomach is very simple, but it does not guarantee health, but only reduces risks. Need to.