Surgery is the main curative treatment for stomach (gastric) cancer that has not spread to distant organs. A partial (subtotal) gastrectomy removes the part of the stomach containing the tumour, while a total gastrectomy removes the entire stomach. Nearby lymph nodes are also removed. The choice depends mainly on where the tumour is located and how far it has spread within the stomach.
How Do Surgeons Decide?
- Tumour location: lower stomach tumours often allow partial removal
- Tumour size and spread: larger or diffuse tumours may need total removal
- Safe margins: enough healthy tissue must be removed around the tumour
- Patient fitness: overall health and nutrition status
What Is a D2 Lymphadenectomy?
It is the removal of lymph nodes around the stomach and major blood vessels. It helps with accurate staging and may improve cancer control when done by experienced teams.
Surgical Approaches
- Open surgery: through an incision in the abdomen
- Laparoscopic or robotic surgery: through small cuts, which may mean less pain and faster recovery for suitable patients
Is Chemotherapy Needed?
Many patients receive chemotherapy before and after surgery, called perioperative chemotherapy. This can shrink the tumour and reduce the risk of recurrence.
Recovery in Hospital
- Hospital stay is often about a week
- Early walking and breathing exercises
- Gradual start of fluids, then soft foods
- Pain control and wound care
Eating After Gastrectomy
- Eat six to eight small meals a day
- Chew well and eat slowly
- Separate liquids from meals by about 30 minutes
- Limit sweets to reduce dumping symptoms
- Include protein at every meal
- Expect some weight loss at first
Long-Term Needs
- Vitamin B12 injections, especially after total gastrectomy
- Iron, calcium and vitamin D monitoring
- Regular follow-up scans and visits
Key Takeaways
- Partial or total gastrectomy depends on tumour location.
- Lymph nodes are removed for staging and control.
- Chemotherapy is often given before and after.
- Small, frequent meals are needed afterward.
- B12 and nutrient monitoring are lifelong needs.
Final Thoughts
Living with part or none of your stomach is very possible with good planning and support. Understanding the surgery helps you prepare physically and emotionally. For stomach cancer surgery evaluation, you can consult Dr. Varadharajan, a surgical oncologist in Chennai.
