Re: Has anyone had a Antrectomy ?

[Guest guest]

Hello Angie.

Angie wrote:

> I was told that I could get some feedback on this surgery here.

I am curious where you heard that. This is not a surgery that is used

much for achalasia. I did a search of the messages and your post seems

to be the only one that uses the term, Antrectomy.

> My Dr.

> is considerng this for non healing gastric ulcers that I have.

I take it you are not responding to medications?

> I am

> hearing all sorts of risks with this. Can anyone share their

> experience with the surgery and recovery?

I don't have any experience with it but I can give you my thoughts on

it. As you know it is the removal of a part of the stomach known as the

antrum. For achalasia this group is more experienced with the removal of

part of the esophagus and the stomach is used to replace it. There are

some similarities between the surgeries so there are some things you may

be able to learn from those here that have had an esophagectomy. Both

surgeries are major surgeries and seem to have similar morbidity and

mortality rates. Those rates can reflect the fact that both surgeries

are often done for patients with cancer who may not be in good health.

Your own risks will also depend on your health, the skill of the surgeon

and the hospital staff. You want to go somewhere they do a lot of these.

Both surgeries require long recoveries. Both surgeries can leave your

stomach much smaller needing small meals. Both surgeries often effect

the vagus nerve resulting in dumping syndrome. Both surgeries often lead

to weight loss. So, people here may not be able to tell you what it was

like to have an antrectomy, but they can tell you what a similar surgery

was like.

There are also some differences. As you probably know removing the

antrum will greatly reduce your acid production. This can lead to

malabsorption of certain nutrients. There is also a risk of bezoars

forming. I would think the risk of that would be low but I don't see a

number for it. And there is a risk of the ulcers returning. Again, I

don't know what the numbers are for that.

I tried to find links to some current articles about the surgery but

most of the detailed information on using it for ulcers is around 10

years old and much of it is more like 20 years old. I believe this is

because with the use of PPIs, H2 blockers and treatments for H. pylori,

there is not much need to treat ulcers with surgery today. Especially if

it is elective surgery. I think it would be used more for bleeding and

perforated ulcers that need emergency treatment. This is just my first

impression because this has never come up in this group before. So don't

put too much faith in this information.

notan

[Guest guest]

To add to Notan It would be very beneficial for you to spend some time in Googles Scholar researching and reading some medical papers, paying attention to who is writing them, I would use keywords associated with the difficulties you are havng and see what comes up. It appears this could be a relatively rare circumstance and you should be able to talk right to some specialists. If any of us can be of more help... we would be happy Carolyn mom of Cameron in N Calif notan ostrich <notan_ostrich@...> wrote: Hello Angie.Angie wrote:> I was told that I could get some feedback on this surgery here. I am curious where you heard that. This is not a surgery that is used much for achalasia. I did a search of the messages and your post seems to be the only one that uses the term, Antrectomy.> My Dr. > is considerng this for non healing gastric ulcers that I have. I take it you are not responding to medications?> I am > hearing all sorts of risks with this. Can anyone share their > experience with the surgery and recovery? I don't have any experience with it but I can give you my thoughts on it. As you know it is the removal of a part of the stomach known as the antrum. For achalasia this group is more experienced with the removal of part of the esophagus and the stomach is used to replace it. There are some

similarities between the surgeries so there are some things you may be able to learn from those here that have had an esophagectomy. Both surgeries are major surgeries and seem to have similar morbidity and mortality rates. Those rates can reflect the fact that both surgeries are often done for patients with cancer who may not be in good health. Your own risks will also depend on your health, the skill of the surgeon and the hospital staff. You want to go somewhere they do a lot of these. Both surgeries require long recoveries. Both surgeries can leave your stomach much smaller needing small meals. Both surgeries often effect the vagus nerve resulting in dumping syndrome. Both surgeries often lead to weight loss. So, people here may not be able to tell you what it was like to have an antrectomy, but they can tell you what a similar surgery was like.There are also some differences. As you probably know removing the

antrum will greatly reduce your acid production. This can lead to malabsorption of certain nutrients. There is also a risk of bezoars forming. I would think the risk of that would be low but I don't see a number for it. And there is a risk of the ulcers returning. Again, I don't know what the numbers are for that.I tried to find links to some current articles about the surgery but most of the detailed information on using it for ulcers is around 10 years old and much of it is more like 20 years old. I believe this is because with the use of PPIs, H2 blockers and treatments for H. pylori, there is not much need to treat ulcers with surgery today. Especially if it is elective surgery. I think it would be used more for bleeding and perforated ulcers that need emergency treatment. This is just my first impression because this has never come up in this group before. So don't put too much faith in this

information.notan 4-H Leader extrodinaire! All-Star Adisor to the most awesome kids of Amador County!

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[Guest guest]

Hi, Well, Notan, my english isn't that good, that I knew an antrectomy means partial removal of the stomach. This post of yours does make me wonder now... As you might know I went to see my surgeon last Thursday. He explained what he's going to do, when he performs surgery. He told me that (of course) the esophagus will be removed (from the neck to the stomach), furthermore half my stomach will be removed and my esophagus will be replaced with the other half of the stomach. Not that it really does matter, but now I wonder, whether this partial removal of my stomach is standard procedure with an -ectomy or not. I know I have serious stomach problems (my stomach empties pretty slowly, kind of achalasia problems in my stomach), so I now wonder if this partial removal of the stomach is part of the -ectomy anyway, or added to mine because of my stomach problems. By the way: my surgeon did tell me that my stomach problems were all the more reason to go for the -ectomy. I need to add, that this of course doesn't have anything to do with my decision, I'll stick to my decision, I am just curious (I'm a woman, you know...). So if you've got an answer (and even if you don't) please let me know. Thanks, Isabellanotan ostrich <notan_ostrich@...> wrote: Hello Angie.Angie

wrote:> I was told that I could get some feedback on this surgery here. I am curious where you heard that. This is not a surgery that is used much for achalasia. I did a search of the messages and your post seems to be the only one that uses the term, Antrectomy.> My Dr. > is considerng this for non healing gastric ulcers that I have. I take it you are not responding to medications?> I am > hearing all sorts of risks with this. Can anyone share their > experience with the surgery and recovery? I don't have any experience with it but I can give you my thoughts on it. As you know it is the removal of a part of the stomach known as the antrum. For achalasia this group is more experienced with the removal of part of the esophagus and the stomach is used to replace it. There are some similarities between the surgeries so there are some things you may be able to learn from those

here that have had an esophagectomy. Both surgeries are major surgeries and seem to have similar morbidity and mortality rates. Those rates can reflect the fact that both surgeries are often done for patients with cancer who may not be in good health. Your own risks will also depend on your health, the skill of the surgeon and the hospital staff. You want to go somewhere they do a lot of these. Both surgeries require long recoveries. Both surgeries can leave your stomach much smaller needing small meals. Both surgeries often effect the vagus nerve resulting in dumping syndrome. Both surgeries often lead to weight loss. So, people here may not be able to tell you what it was like to have an antrectomy, but they can tell you what a similar surgery was like.There are also some differences. As you probably know removing the antrum will greatly reduce your acid production. This can lead to malabsorption of certain

nutrients. There is also a risk of bezoars forming. I would think the risk of that would be low but I don't see a number for it. And there is a risk of the ulcers returning. Again, I don't know what the numbers are for that.I tried to find links to some current articles about the surgery but most of the detailed information on using it for ulcers is around 10 years old and much of it is more like 20 years old. I believe this is because with the use of PPIs, H2 blockers and treatments for H. pylori, there is not much need to treat ulcers with surgery today. Especially if it is elective surgery. I think it would be used more for bleeding and perforated ulcers that need emergency treatment. This is just my first impression because this has never come up in this group before. So don't put too much faith in this information.notan

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[Guest guest]

Isabella Arnold wrote:

....I wonder, whether this partial removal of my stomach is

standard procedure with an -ectomy or not. ...

There are different types of -ectomies, your's being a gastric pull-up.

In doing that procedure the stomach has to be turned into a gastric

tube. Not all of the stomach is used to make it. The rest of the

stomach is removed. Take a look at the following sites and images.

Gastric tube

http://www.ctsnet.org/graphic/gastrictubelarge.jpg

From the article:

Transhiatal Esophagectomy

CTSNet - Cardiothoracic Surgery Network

http://www.ctsnet.org/sections/clinicalresources/thoracic/expert_tech-22.html

The device shown cuts and staples at the same time to make a tube. The

portion connected to the esophagus is removed.

Creation of the gastric tube

http://www.autosuture.com/autosuture/pageBuilder.aspx?contentID=132041 & webPageID=0 & topicID=132023 & breadcrumbs=#pageContent

Gastric tube is formed with a stapler

http://www.uihealthcare.com/news/currents/vol5issue4/01fig3.html

notan