The removal of some or all of the stomach is required for ulcer disease and for gastric tumours. The amount stomach depends on the location and nature of the disease. A cancer at the very bottom of the stomach will require a distal gastrectomy, which involves removing the bottom half of the stomach. Cancers higher in the stomach will require a subtotal or total gastrectomy.
In addition to removing stomach, a gastrectomy for cancer also involves removing adjacent fatty aprons and regional lymph nodes. This is not necessary when surgery is performed for reasons other than cancer.
After the stomach portion is removed the small intestine is used to join things up. There are several different approaches and these will be discussed with you.
There are a number of potential problems that might arise after a gastrectomy, including dumping, weight loss and diarrhoea. These will be discussed with you.
There is an important role for chemotherapy in the treatment of stomach cancer, and for this reason the patient will be referred for chemotherapy before surgery and may well be a candidate for it after surgery, as well.