Gastric Resection

Surgery is the main curative treatment for cancers and tumours of the stomach. Gastric resection is used for:

• Gastric (stomach) cancer - most commonly adenocarcinoma
• Gastrointestinal stromal tumours (GISTs) arising in the stomach wall
• Neuroendocrine tumours of the stomach
• Other benign or pre-cancerous gastric tumours and polyps that cannot be removed endoscopically

Small tumours confined to the stomach lining can sometimes be removed by gastroscopy alone. Your surgeon will review your scans and biopsies with the multidisciplinary team to recommend the most appropriate treatment.

Wedge resection

A small section of the stomach wall containing the tumour is removed. This is often suitable for GISTs and can usually be performed laparoscopically.

Partial (subtotal) gastrectomy

The lower part of the stomach is removed and the remaining stomach is joined to the small bowel. It is used for tumours in the lower half of the stomach.

Total gastrectomy

The whole stomach is removed and the oesophagus is joined directly to the small bowel. It is used for tumours in the upper stomach or where the tumour is extensive.

For cancer, the surrounding lymph nodes are removed at the same time (lymphadenectomy) so that the cancer can be accurately staged and the risk of recurrence reduced. Where appropriate, gastric resections are performed using laparoscopic (keyhole) techniques.

All gastric cancers are discussed at a multidisciplinary team (MDT) meeting with medical oncologists, radiation oncologists, gastroenterologists, radiologists and pathologists. Many patients receive chemotherapy before and after surgery (perioperative chemotherapy) to improve outcomes, and this is coordinated with our medical oncology colleagues within Sydney Surgical Oncology.

Most patients spend five to ten days in hospital after a gastrectomy. Eating is reintroduced gradually, starting with fluids and progressing to small, frequent meals. A dietitian will guide you through these changes, and after a total gastrectomy regular vitamin B12 injections are needed for life because the stomach is no longer there to absorb it.

Many people lose some weight in the months after surgery before it stabilises. Strenuous activity should be avoided for four to six weeks, and follow-up includes regular reviews, blood tests and surveillance scans.