Gastric cancer is a malignant disease of stomach. The treatment primary includes surgical resection of the tumor and surrounding tissue which means that stomach will be resected as well either partially or in total. The surgery is conducted only in tumors in early stages of the disease. If cancer spread too much or in case of metastases there are also several surgical procedures which are done in order to improve life of a patient. The surgery is not single option in treating this horrible disease. There are several modalities that are usually combined.
The surgery that includes the removal of the stomach is called gastrectomy. It also includes the resection of nearby lymph nodes as they have to examined in order to check if they are affected by tumor tissue. After the surgery the treatment continues with chemotherapeutics and/ or radiotherapy. As in any other surgery when cancers are involved where the goal is complete and removal of the tumor. Depending on the stage of the disease patients can undergo total resection of the stomach or may be left with some parts of it.
Total gastrectomy means that the entire stomach is removed together with surrounding lymph nodes. Esophagus is then reconnected to small intestines. This is definitely the most conducted surgery of all gastrectomies. It is done under general anesthesia and the recovery time takes rather long. There are postoperative problems regarding eating but patients get use to new dietary regimes pretty fast.
Subtotal gastrectomy is surgical procedure in which only parts of stomach are resected. This operation does not lead to great handicap since parts of the stomach are left and one may not experience too many postoperative problems connected to eating. Still even these patients have to stick to new dietary regimes. They have better quality of life than patients who have undergone total gastrectomy.
Both of the mentioned procedures carry certain postoperative risks. These include pneumonia and problems with leakage at the spot where esophagus has been stitched to small intestines. Dumping syndrome is one additional complication in majority of patients after the surgical removal of stomach. In case that cancer has been diagnosed in very early stages including stage 0 and I the tumor can be removed by simple endoscopic surgery. These tumors can also be resected by laparoscopic surgery. Japan is leading country in laparoscopic surgery for early stomach cancers as this country has enormously increased number of new cases and prevention and early detection of this form of cancer have been well organized.