NCCN Guidelines for Patients
Stomach Cancer, Version 1.2016
Overview of cancer treatments Surgical treatment
Lymph node dissection
During the gastrectomy, some lymph nodes near to
your stomach will be removed, too. This is called a
lymph node dissection. Removal of at least 15 lymph
nodes is advised.
A D1 dissection removes lymph nodes right next to
the stomach. A D2 dissection removes D1 nodes as
well as lymph nodes next to nearby arteries and your
spleen. A pathologist will test your lymph nodes for
cancer so your surgeon knows if more tissue should
Surgery removes tissue from your body through cuts
(incisions) made with a surgical knife. Gastrectomy
can be performed by three methods. An open
gastrectomy is one method that removes tissue
through a large cut in your belly area.
Laparoscopic or robotic gastrectomy removes tissue
with small tools that are inserted through small cuts.
Because small cuts are used, doctors describe these
methods as “minimally invasive.” Laparoscopic or
robotic gastrectomy is appropriate for some but not
all stomach cancers. Your surgeon will discuss with
you whether your stomach cancer can be removed by
After the cancer is removed, your remaining organs
will be attached. For a total gastrectomy, your small
intestine will be attached to your esophagus. For
a subtotal or distal gastrectomy, your remaining
stomach will be attached to your intestine or
The entire surgery can take 2 to 3 hours to complete.
Most people stay in the hospital about one week to
recover. As you heal from surgery, you will receive
nutrition through a needle placed in your vein or
receive food through a feeding tube.
Side effects of surgery
Surgery causes pain, swelling, and scars. Pain and
swelling often fade away in the weeks following
surgery. As with any surgery, there is a chance of
infection, heart attack, or a blood clot.
Side effects of a gastrectomy differ between people.
You may have few or many side effects. Side effects
of a gastrectomy include nausea, vomiting, and
diarrhea. You may lose weight or not absorb enough
vitamins. Gastrectomy can cause heartburn (acid
reflux). Long-term leakage of stomach acid can scar
and constrict your esophagus. Less often, food may
leak from your stomach into your chest and cause
Not all side effects of surgery are listed here. Please
ask your treatment team for a complete list of
common and rare side effects. If a side effect bothers
you, tell your treatment team. There may be ways to
help you feel better.