Stomach Cancer Treatment

Surgical resection is the most effective stomach cancer treatment. This stomach cancer treatment could be a total gastrectomy, a radical subtotal gastrectomy, or a proximal subtotal gastrectomy.

A total gastrectomy may be performed for a resectable lesion in the midportion or body of the stomach. Linitis plastica is usually treated with a total gastrectomy because of the extensive tumor involvement of the stomach wall.

During this stomach cancer treatment, the entire stomach is excised in bloc, along with resected duodenum, a section of abdominal esophagus, supporting mesentery and lymph nodes. Reconstruction of the alimentary tract is achieved with the use of a jejunal segment anastamosed to the remaining esophagus.

Lesions located in the middle and distal portions of the stomach are treated with a radical subtotal gastrectomy. A Billroth I or Billroth II operations will be performed. The Billroth I stomach cancer treatment, or gastroduodenostomy, involves resection of the distal stomach, pylorus, first portion of the duodenum, and supporting lymph and vasculature.

The remaining stomach is then anastomosed to the duodenum. The Billroth I involves a limited amount of resection, and as a result generally produces a lower cure rate than the Billroth II. The Billroth I stomach cancer treatment is utilized primarily when the patient is debilitated and needs restricted intraoperative time.

A Billroth II stomach cancer treatment is a wider resection that includes removing approximately 75% of the stomach, thereby decreasing the possibility of a nodal or metastic recurrence. The Billroth II involves removal of the antrum, pylorus, first part of the duodenum, supporting vasculature, and all visible and palpable lymph nodes.

The remaining stomach is anastamosed end-to-side to the jejunum. The duodenal stump is then oversewn with sutures. Gastric emptying is altered by both the Billroth I and II stomach cancer treatment, as well as with the total gastrectomy. This is also potential for a duodenal stump leak following the Billroth II procedure.

A proximal subtotal gastrectomy is a stomach cancer treatment that can be performed for a resectable tumor located in the proximal portion of the stomach or cardia. In many cases, a total gastrectomy or an esophagogastrectomy will be performed in place of this stomach cancer treatment to achieve a more extensive resection.

Following resection of the stomach and digestal esophagus, the esophagus is anastamosed to the duodenum of jejunum. Potential complications include pneumonia, anastamotic leak, infection, reflux aspiration, and esophagitis.

Unfortunately, many patients with stomach cancer are not candidates for extensive curative resection. Often symptoms of advanced stomach cancer are so severe that they significantly affect a person's quality of life and will require palliative stomach surgery treatment.