Surgery for stomach cancer
Surgery aims to remove all of the stomach cancer while keeping as much normal tissue as possible. The surgeon will remove some healthy tissue around the cancer to reduce the risk of the cancer returning. You may have an endoscopic resection or a gastrectomy depending on where the tumour is growing and how advanced the cancer is.
Learn more about:
- Endoscopic resection (ER)
- How the surgery is done
- Risks of stomach surgery
- Feeding tubes
- What to expect after stomach surgery
- Common questions about surgery
Very early-stage tumours that have not spread from the stomach walls may be removed with an endoscope. For some people, an endoscopic resection may be the only treatment needed. This is usually an overnight-stay procedure. Preparation and recovery are similar to endoscopy, but there is a higher risk of bleeding or getting a small tear or hole in the stomach (perforation).
This procedure removes part or all of the stomach, leaving as much healthy tissue as possible. The goal is to completely cut out the cancer, including any nearby affected lymph nodes.
Subtotal or partial gastrectomy
The cancerous part of the stomach is removed, along with nearby fatty tissue (omentum) and lymph nodes. The upper stomach and oesophagus are usually left in place.
The whole stomach is removed, along with nearby fatty tissue (omentum), lymph nodes and parts of nearby organs, if necessary. The surgeon reconnects the oesophagus to the small bowel. The top part of this connection (which is a tube of intestine) takes over some of the stomach’s function.
Lymphadenectomy (lymph node dissection)
As the cancer might have spread to nearby lymph nodes, your doctor will usually remove some lymph nodes from around your stomach. This reduces the risk of leaving any cancer behind.
The surgery will be done under a general anaesthetic. There are two ways to perform a gastrectomy:
- in a laparotomy (open surgery), the procedure is done through a long cut in the upper part of the stomach
- in a laparoscopy (keyhole surgery), the surgeon will make some small cuts in the abdomen, then insert a thin instrument with a light and camera (laparoscope) into one of the cuts. The surgeon inserts tools into the other cuts and performs the surgery using the images from the camera for guidance.
The hospital stay and recovery time are fairly similar for both types of surgery. Laparoscopic surgery usually means a smaller scar, however, open surgery may be considered a better option in many situations.
As with any major surgery, stomach surgery has risks. These may include infection, bleeding, increased strain on the heart and lungs, damage to nearby organs, or leaking from the connections between the small bowel and either the oesophagus or stomach. Some people experience an irregular heartbeat, but this usually settles in a few days.
You will be carefully monitored for any side effects. For more information about ongoing effects after surgery, see Managing side effects.
Podcast: Making Treatment Decisions
Prof David Watson, Senior Consultant Surgeon, Oesophago-gastric Surgery Unit, Flinders Medical Centre, and Matthew Flinders Distinguished Professor of Surgery, Flinders University, SA; Kate Barber, 13 11 20 Consultant, Cancer Council Victoria; Katie Benton, Advanced Dietitian, Cancer Care, Sunshine Coast Hospital and Health Service, QLD; Alana Fitzgibbon, Clinical Nurse Consultant, Gastrointestinal Cancers, Royal Hobart Hospital, TAS; Christine Froude, Consumer; Dr Andrew Oar, Radiation Oncologist, Icon Cancer Centre, Gold Coast University Hospital, QLD; Dr Spiro Raftopoulos, Interventional Endoscopist and Consultant Gastroenterologist, Sir Charles Gairdner Hospital, WA; Grant Wilson, Consumer; Prof Desmond Yip, Clinical Director, Department of Medical Oncology, The Canberra Hospital, ACT. We also thank the health professionals, consumers and editorial teams who have worked on previous editions of this title.
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