Stomach Cancer Surgery
Stomach cancer surgery may be recommended in conjunction with other treatments, such as chemotherapy, radiation therapy or molecular targeted therapy, to address gastric cancer. To determine whether a patient is a surgical candidate, several key factors will be considered, including the type, size, location, grade and stage of the tumor, as well as the patient’s age and general health.
Surgical options for stomach cancer
If a tumor is determined to be removable (resectable), a surgeon may recommend one of the following types of stomach cancer surgery.
Endoscopic resection
Endoscopic resection is most commonly used for early-stage stomach cancers with a low chance of metastasis to the lymph nodes. This procedure is done using an endoscope – a long tube with a camera on the end – which is passed down the throat into the stomach. Small, intricate surgical tools can be passed through the endoscope to remove the tumor and surrounding tissue.
Partial gastrectomy
This procedure is used when the cancer is located in only part of the stomach. Only part of the stomach is removed during a partial gastrectomy, leaving the unaffected portion of the stomach to be reattached to make eating easier following surgery. Sometimes part of the esophagus or small intestine may be removed, as well as nearby lymph nodes and possibly other organs.
Total gastrectomy
This procedure is recommended if the cancer has spread throughout the stomach (it is sometimes necessary if the cancer is in just part of the stomach, such as when it is in the upper part of the stomach near the esophagus). The difference between a total gastrectomy and a partial gastrectomy is that this procedure involves the removal of the entire stomach. The end of the esophagus is connected to the small intestine to allow for food passage.
Proximal gastrectomy
This procedure is used for very small/early tumors at the top of the stomach near the junction between the esophagus and stomach. A small portion of the lower stomach is preserved to help maintain some of the functions of the stomach. Significant acid reflux could be a side effect of this operation.
Robotic surgery
Minimally invasive techniques are routinely used to treat gastroesophageal cancers. Robotic surgery allows surgeons to effectively remove the cancer while minimizing scarring, reducing pain and helping patients recover more quickly. A surgical oncologist may also recommend a prophylactic robotic gastrectomy, the removal of the entire stomach before cancer develops, for patients at very high risk of developing stomach cancer.
Hyperthermic (heated) intraperitoneal chemotherapy (HIPEC)
A surgical approach that can be used for select patients to treat tumors that have spread inside the abdominal cavity, known as peritoneal disease. HIPEC is administered in a single session that takes place immediately after the surgical procedure is completed and allows for a higher concentration of the drug to reach the tumor. At times, when the amount of peritoneal disease is small, our team may perform minimally invasive HIPEC before gastrectomy.
Stomach Cancer Outcomes
The primary aim of cancer treatment is to attain the best possible outcome with minimal side effects, ensuring the highest quality of life for the patient. On average, Moffitt's stomach cancer treatment survival rates exceed 1.5 times the national average.
Surgical options for unresectable stomach cancer
Alternatively, if a nonremovable tumor is causing symptoms of blocking the stomach and inhibiting digestion, a surgeon may recommend one of the following types of stomach cancer surgery.
Stent placement
With this procedure, a stent is placed between the stomach and small intestine, or between the stomach and the esophagus. A stent is a thin, hollow tube that is used to keep the passageway to the stomach open to allow the passage of food.
Endoscopic tumor ablation
A surgeon can use an endoscope (a long tube with a camera on the end) to vaporize part of a stomach tumor using a focused laser beam. For gastric cancers, tumor ablation alone rarely provides long-term improvement.
Endoscopic or surgical bypass
In some cases, when the stomach is blocked by a tumor, a bypass can help. A bypass works by sending food around the blockage to another part of the intestines. Sometimes this can be done using an endoscope (a flexible tube with a camera) in a minimally invasive fashion without external cuts, but in other cases, surgery is needed to rearrange the intestines and help food pass through. Even when surgery is not expected to cure the cancer, a bypass procedure can help relieve nausea and vomiting, allow patients to eat again, and make it possible to receive additional treatments.
How long does it take to recover from stomach cancer surgery?
Recovering from stomach cancer surgery often takes a few weeks, as the digestive system needs time to heal. Depending on whether a patient has a partial or total gastrectomy, the hospital stay is typically several days to about a week after surgery. Although the patient can eat a variety of foods, sometimes it takes a few months before they have a full understanding of which foods agree with them. As the body adjusts to changes in digestion, some patients may experience weight loss during recovery.
ACS Surgical Quality Partner for 30+ Years
Continuously Accredited by the American College of Surgeons Commission on Cancer since 1989 for our commitment to providing comprehensive, high-quality and multispecialty patient-centered care.
Why choose Moffitt for stomach cancer surgery?
Patients who undergo stomach cancer surgery at Moffitt Cancer Center are the focus of a multispecialty team of world-class surgeons and other cancer experts. Our talented tumor board collaboratively discusses the patient’s case on a weekly basis and refines treatment as necessary to ensure the highest level of individualized care. We understand that gastric cancer can have a significant impact on every aspect of a patient’s life, and we are committed to doing everything possible to help our patients cope and adjust.
Additionally, because stomach cancer surgery is highly complex and specialized, a patient’s greatest chance for a successful outcome is with a surgeon who has extensive experience and refined skills. The data is clear that higher volumes of cases by a surgeon are associated with better outcomes. Moffitt treats a high number of gastric cancer patients. As a result, our surgeons perform many intricate procedures each year and achieve better outcomes than most other cancer centers. Moffitt’s scientists and clinicians have pioneered many improvements in stomach cancer treatment, and every day we gain ground in finding a cure.
Medically reviewed by Michael Wach, MD, and Dr. Jose Pimiento, Gastrointestinal Oncology Program.
For more information about stomach cancer surgery and other treatment options, call 1-888-663-3488 or complete a new patient registration form. We accept patients with and without referrals.
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