Surgical Procedures for Stomach Cancer
by Rosalyn Carson-DeWitt, MD
The primary treatment for stomach cancer is surgery. The goal of treatment is to remove as much of the cancer as possible, while preserving the stomach and its function. It is often used in combination with other treatments. Chemoradiation, a combination of radiation therapy and chemotherapy may be used before surgery to shrink the tumor or to try to kill off any remaining cancer cells after surgery. Surgical removal is not always an option since most stomach cancers are found in advanced stages.
Gastric surgeries are long and difficult procedures that often have postoperative complications. It is important to seek out an experienced surgeon and hospital for these procedures.
Surgery for Early Stage Stomach Cancer
Endoscopic mucosal resection (EMR) is a procedure to remove small, noninvasive cancer during an endoscopy. A tube with a lighted tip and camera is inserted through the mouth and throat. The tumor is removed along with a margin of healthy tissue to try to ensure that all the cancer is completely removed. The doctor will examine and take samples of the removed tissue. Tissue samples will be examined under a microscope for the presence of cancer.
This procedure is not as common in the US because most stomach cancers are found in advanced stages. It is usually done in countries where stomach cancer is more common and found earlier because of screening.
Surgery for Advanced Stomach Cancer
A gastrectomy is the removal of part or all of the stomach. The amount of tissue removed depends on the location and size of the tumor. Nearby lymph nodes may also be removed and tested for the presence of cancer. Cancer in the lymph nodes means the cancer may have spread to other areas of the body.
Types of gastrectomies:
Gastrectomies can be done as:
A feeding tube can be inserted through the abdominal wall and directly into the small intestine. This is done when eating is difficult and nutritional needs are not able to be met. Nutritional support helps prevent starvation, as well as aspiration of material into the lungs.
People who have a gastrectomy have smaller stomachs. In order to get proper nutrition, some dietary changes need to be made. The most common approaches include:
Surgery may not be effective for managing cancer itself but may be needed to relieve complications and improve quality of life. Most of these procedures are done during an endoscopy and may include:
Gastric carcinoma. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T116155/Gastric-carcinoma . Updated September 27, 2016. Accessed September 1, 2017.
Gastric cancer. National Cancer Institute website. Available at: https://www.cancer.gov/types/stomach/patient/stomach-treatment-pdq. Updated April 27, 2017. Accessed September 1, 2017.
Stomach cancer. Merck Manual Professional Version website. Available at:
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Updated January 2017. Accessed September 1, 2017.
Surgery for stomach cancer. American Cancer Society website. Available at: https://www.cancer.org/cancer/stomach-cancer/treating/types-of-surgery.html. Updated March 15, 2016. Accessed September 1, 2017.
Last reviewed September 2018 by EBSCO Medical Review Board Michael Woods, MD, FAAP
Last Updated: 6/29/2017
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