Surgery for Gastric Cancer

If you have stage 0, I, II, or III, your doctor will probably recommend surgery to try to cure the cancer. If you have stage IV cancer that has not spread to distant parts of the body, surgery can help prevent certain complications.

The type of surgery you have will depend on the location of the cancer in your stomach and how far it has spread into tissues near the stomach. The main types of surgery for gastric cancer are described below.

• Endoscopic mucosal resection - The surgeon passes a long, flexible tube called an endoscope down your throat and into your stomach. He or she uses the endoscope to remove the tumor. This procedure is only used for stage 0 and early stage I cancers that have not spread to the lymph nodes (small organs that help the body fight infection) near the stomach.
• Partial (subtotal) gastrectomy - The surgeon removes the part of the stomach that contains the cancer, as well as some of the normal stomach tissue around the cancer. Sometimes he or she also takes out part of the esophagus or intestine, the spleen (an organ that filters blood and destroys old blood cells), and the lymph nodes near the stomach. The surgeon then reattaches the part of the stomach that is left to the small intestine or esophagus. Since your stomach will be smaller, it will only be able to store a small amount of food. So you will only be able to eat a small amount of food at a time. This means that you will need to eat more often.
• Total gastrectomy - The surgeon removes the entire stomach. The surgeon might also take out the spleen, nearby lymph nodes, and parts of other organs (such as the esophagus, intestines, and pancreas). After removing these organs, the surgeon attaches the end of the esophagus to the small intestine to make a replacement stomach out of intestinal tissue. Your food can be stored in this new stomach before it moves down the intestinal tract. This replacement stomach can only store a small amount of food. So you will only be able to eat a small amount of food at a time. This means that you will need to eat more often.

This content has been reviewed and approved by Myo Thant, MD.