What is the common reason for performing a total gastrectomy?

Total gastrectomy is most commonly performed for malignancy, particularly gastric cancer. This surgical procedure involves the complete removal of the stomach and is often indicated when cancer is diagnosed at a stage where it cannot be treated effectively through less invasive means. Gastric cancer can present with symptoms that require a significant intervention, leading to decisions for total gastrectomy to remove the tumor and prevent further metastasis.

While other conditions, such as severe peptic ulcer disease or gastroesophageal reflux disease, can lead to significant morbidity and may require surgical treatment, total gastrectomy is not typically the first-line intervention for these conditions. Additionally, obesity is generally addressed through bariatric surgical procedures that preserve stomach function rather than removing the entire stomach, which would not be an effective approach for weight management. Thus, malignancy remains the primary indication for this extensive surgery.