Gastric cancer surgery will involve removing all or part of the stomach along with neighboring lymph nodes and other structures, if the cancer has spread. It is invasive, and patients should expect a long recovery period, during which they may need to make some significant dietary changes. Chemotherapy is also an option before and after surgery and may complicate recovery, as it tends to make patients feel extremely ill.
Before gastric cancer surgery can take place, a doctor will want to collect as much information as possible. She will order medical imaging studies of the stomach and surrounding area and could request a biopsy to learn more about the cancer. The patient may need a blood test to check for risk factors like abnormal hormone levels, and he will meet with the surgeon and anesthesiologist to talk about options and get a careful screening for any potential contraindications for surgery. Patients should be frank about their medical history, as concealing information could put them at risk on the operating table.
In some cases, the patient will start taking chemotherapy to attack the cancer before the surgery. In others, the surgeon may recommend waiting. On the day of the surgery, the patient needs to refrain from taking food or drink, and should talk to her doctor ahead of time about taking any medications. Sometimes a doctor may recommend temporarily stopping drugs that might cause bleeding or other complications in surgery. The patient will also meet with the surgeon a final time to discuss risks and sign a consent form.
At the hospital, the patient will receive a mild sedative to relax while nurses prepare him for surgery. Surgical preparation typically includes placing an intravenous catheter for venous access and confirming that the patient knows what the surgery is for. When the surgeon is ready, the anesthesiologist will induce anesthesia and monitor the patient's breathing and heart rate throughout the surgery.
A surgeon may be able to offer endoscopic gastric cancer surgery, where she goes in through small incisions to access the area of interest. This limits scarring and pain, as the patient will not have a large surgical incision. This is not always an option, and sometimes the surgeon needs to switch to open surgery to get better access. The surgeon will take out the tumor and surrounding tissue, and may ask a pathologist to examine the margins and confirm that all of the tumor is out.
After the surgery is complete, the anesthesiologist can bring the patient out of anesthesia and move him to recovery, where personnel will monitor him for side effects. Patients should expect to experience pain and nausea after gastric cancer surgery, and nurses will provide medications to help with both of these. For the first few days of recovery, it is necessary to drink only clear fluids. The patient can gradually work through soft solids and other foods. Patients may need to change their eating habits after gastric cancer surgery. It is usually necessary to eat several small meals a day rather than one large one, and supplements may be necessary to meet dietary needs. Patients should also be aware that they may experience diarrhea and other stool changes for around six months after surgery.