Tumors which involve the proximal part of the stomach or the entire stomach will need a a total gastrectomywhere the entire stomach is removed. The end of the esophagus (food pipe) is joined to the loop of small intestine to restore continuity. Usually, the omentum (fat layer arising from the stomach) is completely removed as part of the resection.
The surgery also involves a complete lymph node clearance of the affected area which is called a D2 Lymphadenectomy. This is one of the key steps in ensuring a complete resection and reduces risk of recurrence.
Some of these surgeries can be done by laparoscopy or robotic technique but it is usually only for very early stage tumors. Complete and radical surgery is the only way to ensure a good outcome in gastric cancer.
This surgery is usually well tolerated. Patients may need to adjust their meals to small frequent portions and take vitamin supplements.