Pathophysiology of gastric surgery, gastric resection is the surgical treatment of gastric cancer surgical methods used. Application is usually more proximal and distal gastrectomy and total gastrectomy and lymph node dissection as the number of remaining residual stomach and the presence of a direct impact on patient food digestion, absorption and nutritional disorders, especially in extended radical resection of gastric cancer must play a lot after digestion and absorption, nutritional changes, equipment safety concerns in this regard over the years.
Gastric resection caused by the anatomy and function can often cause damage to digestion, absorption, reasons:
(1) stomach volume smaller or no stomach to reduce food intake, reduced pepsin commanded loss, and poor iron absorption.
(2) food through the gastrointestinal non-physical structure and ways to make food through faster, mixed with digestive enzymes is not sufficient to teach other intestinal membrane damage or home, resulting in malabsorption.
Pathophysiology of gastric cancer after surgery (3) stimulation of gastric secretion of duodenal gastrin loss or damage area. Secretin secretion cells were mainly distributed in the antrum and duodenum, in order to stimulate the gastric mucosa caused by food, gastrin secretion affect the secretion of hydrochloric acid solution with the membrane. Hormone secreting cells in the casting solution to promote mainly in the duodenum, the hydrochloric acid can stimulate a good way to promote the secretion of membrane enzymes and thus affect the membrane fluid, bile and bicarbonate secretion Li. There clinical anorexia or loss of appetite, indigestion, diarrhea and other symptoms.
(4) perigastric organs, nerves and other complications caused by removal, such as joint extended resection can lead to diabetes, the body and tail membranes are widely removed lymph nodes, distressed by the removal of plants can cause biliary function and intestinal motility disorder, disaster postoperative gallbladder , gallstone disease, diarrhea, abdominal distension syndrome.
Gastrectomy complications occurred more commonly described here focus on several complications.
1. Dumping syndrome points early and late dumping syndrome, the former more common.
(1) causes: not yet entirely clear, but reconstruction after gastrectomy is an important factor. Bi-type reconstruction after 20%, about 15% after completion of ceremony. The smaller the residual stomach, the more prone, more severe. After total gastrectomy the incidence of dumping syndrome in most patients after about 3 times.
Pathophysiology of gastric surgery, (2) methods of prevention: The general principle is radical gastrectomy, gastrointestinal tract, as far as possible to complete type reconstruction. Distal subtotal gastrectomy, in addition to cancer in the pyloric and duodenal invasion round or outside, try the line on the end of the remnant stomach and duodenum anastomosis; proximal subtotal gastrectomy or total gastrectomy should be performed esophagus and remnant stomach (or duodenum) jejunal interposition operation. Set between the popular and easy way to be simplified.