Subtotal (Partial) Gastrectomy

Stomach cancer starts in the lining of the stomach. When it is found early, surgery is often the appropriate way to treat it. A common operation for this is a Subtotal (Partial) Gastrectomy. The surgeon removes the part of the stomach with the cancer, but leaves the healthy part behind so you can still eat and digest food.

Doctors decide to do this after looking at your biopsies and camera tests (endoscopies). It is a major operation performed by specialists in a hospital. Depending on how far the cancer has spread, you might also need chemotherapy. This treatment plan is designed to remove the tumour and help you get better as quickly as possible.

A subtotal (or partial) gastrectomy is an operation to remove part of the stomach. It is most often used when stomach cancer is limited to just one area. The surgeon removes the tumour and a small band of healthy tissue around it. They also remove nearby lymph nodes, because cancer can spread through the lymphatic system, and testing these nodes shows if the disease has moved.

To keep you digesting food, the surgeon joins the remaining part of your stomach directly to your small intestine. You will still be able to digest, though your stomach will be smaller. This surgery works for cancers in the lower or middle stomach. If the cancer is higher up or covers more area, a total gastrectomy is needed.

Doctors may suggest a subtotal gastrectomy to treat stomach cancer. They will check if it is right for you using CT scans, biopsies, and endoscopy. This operation is considered when:

• The cancer is in the middle or lower part of the stomach.
• The cancer is early-stage and localised.
• The surgeon can remove the tumour completely.
• It is part of a plan that may include chemotherapy.
• Keeping part of the stomach will help your digestion.

The tissue extracted from the stomach tumour is sent to a pathology lab for detailed analysis. The report tells doctors about the cancer and lymph nodes, which helps them plan any follow-up treatment.

It is essential to know that a subtotal gastrectomy is just one of many options. Your doctors will carefully assess your health and scans. You might be a candidate based on:

• Your cancer is in the lower part of your stomach.
• Scans show the disease has not spread widely.
• You are fit enough for major surgery.
• Your doctors need to remove the tumour and the nearby lymph nodes.
• Saving part of your stomach is a safe option.

Your care plan is always decided by a specialist team, including surgeons and oncologists.

A subtotal gastrectomy is a major operation, and doctors must be careful when deciding if it is suitable. They will review your health and the cancer's stage before making any decisions. It is generally not suitable for those who:

• Have cancer covering the whole stomach.
• Suffer from serious heart or lung diseases.
• Are not fit enough for such a large operation.
• Have cancer that has spread to other organs.
• Are currently too unwell to handle the stress of surgery.

If surgery is not the right choice, doctors may discuss other options like chemotherapy, targeted therapies, or palliative care.

Subtotal (Partial) Gastrectomy Procedure

While a subtotal gastrectomy is a major operation, you will be looked after by a dedicated team of specialists who do this every day. Everything is set up in the operating room to keep you safe and to monitor you at all times.

The team will take time to explain everything to you and answer your questions so you feel comfortable before you go in. They will review your history and test results to ensure they are fully prepared. To help your recovery, please remember to:

• Fast before the surgery as advised.
• Tell your team about all your medicines.
• Avoid smoking.

Follow your preparation plan.

A subtotal gastrectomy is performed while you are asleep under general anaesthesia. The surgeon will access the stomach either through an incision or using keyhole (laparoscopic) surgery. The part of the stomach containing the tumour, along with the nearby lymph nodes are removed. To make sure you can still digest food, the surgeon joins the remaining stomach to the small intestine.

The team takes great care to check that all surgical connections are checked for integrity. While the surgery may take several hours, it is a significant step toward your recovery, and the team will be with you the entire time.

Following surgery, you are moved immediately to the recovery area for continuous monitoring. You will remain hospitalised for several days as the surgical team tracks your progress. It is crucial to restore your digestive function; therefore, intravenous support will provide essential nutrition until you are ready for oral intake. Once cleared, you must follow the gradual plan for liquids and soft foods. Be prepared for:

• Some mild abdominal discomfort.
• A smaller appetite.
• Feeling full quickly.
• Feeling a bit tired.

These are common and will improve. Our dietitians will help you manage your meals as you recover.

A subtotal gastrectomy is a big operation, so there are some risks involved. Your doctors watch you very closely before, during, and after to help avoid any problems. Possible complications include:

• Bleeding.
• Infection where the cut was made.
• Leaks where the stomach joins the intestine.
• The stomach is emptying too slowly.
• Not getting enough nutrients over time.

Subtotal gastrectomy is used to treat stomach cancer if the disease is confined to a specific area. It allows surgeons to:

• Remove the tumour from the stomach.
• Reduce the chance of cancer spreading.
• Examine lymph nodes to stage the cancer.
• Save a portion of the stomach to help you digest food.
• Provide a foundation for ongoing monitoring.

Because a part of the stomach remains, you will likely find that your digestion returns to a relatively normal state once you have completed your recovery.

Gleneagles Hospitals perform a subtotal gastrectomy as part of our cancer care services. Our surgeons are trained in advanced gastric surgery. We provide:

• Expert gastrointestinal surgery teams.
• Advanced operating rooms for cancer surgery.
• Anaesthesia and critical care support.
• On-site diagnostic and pathology labs.
• Close monitoring during recovery.

You will receive clear instructions before your operation and careful support during your recovery, in line with our standard hospital clinical practices.

A subtotal gastrectomy treats stomach cancer by removing the affected part of the stomach and neighbouring lymph nodes. The stomach is then stitched to the small intestine to allow digestion to proceed. We test the removed tissue to determine the cancer’s stage and inform the next steps. At Gleneagles Hospitals, we only suggest this procedure if our clinical evaluation confirms it is the superior option.