What classification would be assigned to a total gastrectomy?

A total gastrectomy, which involves the complete removal of the stomach, is classified as Class II. This classification pertains to surgical procedures that are considered clean-contaminated, meaning they involve the respiratory, gastrointestinal, or genitourinary tract, but the procedure is conducted in a manner that minimizes contamination.

In the case of a total gastrectomy, although the gastrointestinal tract is involved, the operation is usually performed under controlled conditions with proper surgical protocols, significantly reducing the risk of infection. This makes it distinct from Class I procedures, which are clean operations with no significant contamination risk. Class III and Class IV procedures involve a higher risk of infection due to the nature of the surgery or the presence of established infections, which does not apply in the case of a total gastrectomy when performed electively.

Thus, Class II is the appropriate classification for this procedure based on the level of contamination risk and the management of that risk during the surgery.