Surgery is an important treatment, especially for early-stage stomach cancer, and surgery can even be performed when the cancer has spread beyond the stomach.

It is very major surgery, and some people may not be well enough to have it. You will need to talk to your specialist about the benefits and risks of this operation before coming to a decision.

Most people will need treatment with chemotherapy in addition to surgery. However, if stomach cancer is diagnosed in the earliest stage possible, surgery may be enough. Also, surgery may be the best option if both treatments combined are too intense for you.

The surgery will depend on the location of the tumor and its size. You may have all of your stomach and an area of healthy tissue around the tumor removed to ensure that all the cancer cells have been eliminated. They also remove nearby lymph nodes and the fatty tissue called the omentum that covers the stomach

Depending on the position of the tumor and how far it has spread, the surgeon may remove part of the nearby organs. This may include the lower part of the esophagus, the upper part of the small intestine (duodenum), and, sometimes, the spleen or part of the pancreas.

Surgery to remove part of the stomach.

Depending on the location and size of the tumor, it may be possible to keep part of the stomach, an operation called partial gastrectomy. This operation makes it easier to eat after the surgery.

• If the tumor is in the lower part of the stomach, near the small intestine.
  The surgeon removes the lower part of the stomach and then the duodenum is sewn. The upper stomach is moved down and is reconnected to a different part of the small intestine, forming a smaller stomach.
• If the tumor is in the upper part of the stomach, near the esophagus.
  The surgeon removes the upper part of the stomach and the lowest part of the esophagus; this is known as esophagogastrectomy. The remaining end of the esophagus is joined to the lower stomach.

Surgery to remove the entire stomach.

If the tumor is in the upper or middle part of the stomach, normally all of the stomach is removed; this is called total gastrectomy. The surgeon joins the lower part of the esophagus to a part of the small intestine, making a small sac that can act like a stomach.