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Total gastrectomy and gastrointestinal reconstruction

Pamela Hebbard, MD, FRCS
Section Editor
David I Soybel, MD
Deputy Editor
Wenliang Chen, MD, PhD


The term "total gastrectomy" implies the complete removal of all gastric tissue. Total gastrectomy is the treatment of choice for certain gastric tumors.

Perioperative considerations, surgical techniques for total gastrectomy and gastrointestinal reconstruction, and complications of total gastrectomy are reviewed here. Issues pertaining to partial gastrectomy are discussed elsewhere. (See "Partial gastrectomy and gastrointestinal reconstruction".)

The gastroesophageal junction refers to the point of transition from the abdominal esophagus to the proximal stomach. Carcinomas arising at or near the gastroesophageal junction pose unique challenges, both in their ability to arise from esophageal or gastric mucosa, and in the complexity of jointly resecting the esophagus and stomach. Gastroesophageal junction tumors are reviewed elsewhere. (See "Multimodality approaches to potentially resectable esophagogastric junction and gastric cardia adenocarcinomas".)


The surgical anatomy of the stomach, including the anatomic divisions of the stomach (cardia, fundus, body, antrum, and pyloric sphincter (figure 1)), blood supply, and lymphatic drainage, is reviewed elsewhere (figure 2). (See "Partial gastrectomy and gastrointestinal reconstruction", section on 'Surgical anatomy and physiology of the stomach'.)


Total gastrectomy is indicated in the treatment of certain gastric tumors. These include:

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Literature review current through: Nov 2017. | This topic last updated: Aug 15, 2017.
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