Surgery for Resectable Stomach Cancer
Most stomach cancer treatment plans include surgery, especially if the cancer was caught at an early stage. Surgery can be performed for two main reasons:
- To remove the cancer. This may involve removing part or all of the stomach. Removing some nearby lymph nodes or other structures may also be necessary.
- To relieve symptoms. Surgery may be used to prevent or alleviate symptoms caused by cancer rather than to provide a cure. This is known as palliative surgery.
The type and stage of stomach cancer will influence whether surgery is an option and, if so, which method is best.
Surgical Procedures Used to Remove Stomach Cancer
Endoscopic Resection
This removes the tumor and some layers of the stomach wall using an endoscope, which is inserted through the throat instead of making an incision. Endoscopic resection includes endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD).
Gastrectomy
A gastrectomy procedure removes part or all of the stomach:
- Subtotal (partial) gastrectomy: This removes the part of the stomach containing cancer, nearby lymph nodes, and other tissues and organs near the tumor. The spleen may also be removed.
- Total gastrectomy: This procedure removes the entire stomach, nearby lymph nodes, and parts of the esophagus, small intestine, and other tissues near the tumor. The spleen may also be removed. The end of the esophagus is then attached to part of the small intestine so the patient can continue to eat and swallow.
Most subtotal and total gastrectomies are performed through a large incision in the abdomen. In some cases, the surgeon may attempt a laparoscopic approach instead.
Palliative Surgery for Unresectable Stomach Cancer
If your stomach cancer cannot be completely removed, surgery to help control the cancer or alleviate symptoms will likely be recommended. This may include:
- Gastrojejunostomy: The cancerous section of the stomach blocking the opening into the small intestine is removed, and the stomach is connected to the jejunum (a part of the small intestine) to allow food and medicine to pass through.
- Feeding tube placement: A minor operation can be performed to insert a feeding tube through the skin of the abdomen into the lower part of the stomach. This helps those who cannot receive adequate nutrition due to the effects of cancer.
- Upper endoscopy: Endoscopic tumor ablation, which uses a laser to vaporize the tumor, or stent placement to keep a tumor from blocking the opening at the beginning or end of the stomach, are two procedures that can help relieve symptoms.
