If you have stomach cancer or a CDH1 genetic mutation that significantly increases your risk of developing stomach cancer, you may have surgery as part of your treatment. The goal of surgery is to eliminate your cancer or your risk of developing stomach cancer.
Surgery may also improve your quality of life by making you more comfortable, as well as helping you eat more easily.
We offer two types of surgery for stomach cancers — partial gastrectomy and total gastrectomy — and we’ll work with you to determine which type is best for you.
A partial gastrectomy involves the removal of part of your stomach. How much of your stomach is removed will depend on the location of your tumor.
Generally, we will divide your stomach, and the lower half of it, as well as the tumor and regional lymph nodes, will be removed. Your lymph nodes will be examined by a pathologist to determine whether your stomach cancer has spread. This can help inform further treatment, as well as help provide regional control of your tumor.
Your gastrointestinal (GI) tract is then reconstructed. To reconstruct your GI tract, we’ll bring a loop of intestine up to your stomach and create a new connection for food to pass through during digestion.
Partial gastrectomies are most often performed as open surgeries under general anesthesia; however, we may determine that you are a candidate for a laparoscopic-assisted partial gastrectomy. Laparoscopic-assisted procedures require smaller incisions and often lead to a shortened recovery time.
A total gastrectomy involves the removal of your entire stomach. After your stomach is removed, we will attach your esophagus to your small intestine and create a new connection for food to pass through during digestion.
You’ll have a total gastrectomy if your stomach cancer is in the upper portion of your stomach, requiring us to divide the lower part of your esophagus and remove your stomach.
You might also choose to have a total gastrectomy if you have a CDH1 genetic mutation.
Total gastrectomies are most often performed as open surgeries under general anesthesia; however, we may determine that you are a candidate for a laparoscopic-assisted approach.
Preparing for a Gastrectomy
Regardless of whether you are having a partial or total gastrectomy, it is important that you are in your best possible health before your surgery to make your recovery easier. You should participate in regular aerobic exercise as well as eat a balanced diet. We can develop an exercise and nutrition plan that’s best for you.
We'll also give you specific instructions on when to stop eating, drinking and taking medications in the days and weeks before your surgery. It's very important that you follow these guidelines for your own safety, and you'll need to have an empty stomach before any surgical procedure that requires anesthesia. If you don't follow the instructions, your surgery might be canceled. Please contact us with any specific questions.
Recovering from a Gastrectomy
The recovery process will depend on how much of your stomach is removed.
If you are having a partial gastrectomy, you can expect to spend up to five days recovering in the hospital after surgery. You’ll likely lose weight in the month after surgery and can usually resume your normal eating schedule within six months.
If you are having a total gastrectomy, you’ll need to make more significant, long-term lifestyle changes. You’ll spend about six to 10 days in the hospital recovering from surgery, then require close, careful follow-up, coaching and support for several months after surgery to ensure you are getting adequate nutrition and recovering well. You’ll work with your cancer team, including a registered dietitian, throughout your recovery.
No matter which procedure you have, you won’t be able to eat anything within the first few days after surgery. Instead, you’ll be fed through an IV or feeding tube. This gives your digestive tract time to heal. Later, you’ll progress to a liquid diet, then a soft-food diet, until you are able to handle harder foods.