Stomach Cancer Surgery in Ankara, Turkey

Stomach cancer surgery is the main treatment method used to remove malignant tumors that develop in the stomach tissue. The surgical procedure can be performed with different techniques depending on the stage of the tumor and the patient’s overall health condition.

Gastrectomy is the most commonly performed procedure for stomach cancer. With partial or total gastrectomy, the tumor-bearing tissue and surrounding lymph nodes are removed to try to prevent the spread of cancer. This procedure is performed in accordance with oncologic principles.

Laparoscopic methods can also be used in stomach cancer surgery. Compared to open surgery, this method offers less trauma, faster recovery, and a shorter hospital stay. In this way, the patient’s quality of life is also improved.

In the post-operative period, a personalized nutrition plan is created for patients. Regulating vitamin and mineral absorption, preventing weight loss, and regular oncologic follow-up are critical for long-term survival.

You can contact Prof. Dr. Ebru Soy, one of the doctors performing Stomach Cancer Surgery in Ankara, to get information about Stomach Cancer Surgery prices, the process, and the hospital where Stomach Cancer Surgery is performed.

What Is Stomach Cancer?

Stomach cancer is a malignant tumor that occurs due to uncontrolled growth of the cells lining the inner surface of the stomach. The most common type is adenocarcinoma. It may not cause symptoms in the early stages; as it progresses, symptoms such as weight loss, loss of appetite, stomach pain, nausea, and early satiety may occur. Risk factors include Helicobacter pylori infection, smoking, excessively salty foods, and genetic predisposition. Treatment may include surgery, chemotherapy, and radiotherapy.

What Is Stomach Cancer Surgery?

Thinking of stomach cancer surgery as simply removing the visible mass in the stomach is an incomplete approach. This surgery is a much more comprehensive clearance procedure based on the fundamental principles of oncologic surgery. You can think of cancer like an invasive weed overtaking your garden. Just pulling off the part you can see is not enough; what really matters is clearing its roots underground and the seeds that have the potential to spread. That is exactly what stomach cancer surgery aims to do.

The surgery has two main objectives. The first is to completely remove the cancerous tissue with a “safe margin,” meaning leaving a small amount of healthy tissue around it. This minimizes the risk of the disease recurring in the same location. The second, and perhaps more critical, objective is the removal of lymph nodes. Cancer cells often use lymphatic pathways to spread throughout the body. Lymph nodes are checkpoints along these pathways. During surgery, these lymph nodes around the stomach and around the main vessels supplying the stomach are carefully removed.

This clearance provides two major benefits. On the one hand, if the cancer has spread to these nodes, removing them helps stop the spread of the disease; this is the treatment itself. On the other hand, pathological examination of the removed lymph nodes shows us how far the cancer has actually spread, meaning the definitive stage of the disease. This invaluable information guides the decision on whether additional treatments such as chemotherapy are needed after surgery. In short, this operation is both a treatment method and the most important diagnostic tool that maps the disease.

In Which Cases Is Stomach Cancer Surgery Performed?

When deciding on stomach cancer surgery, the most determining factor is the stage of the disease, meaning how deeply the cancer has penetrated the stomach and whether it has spread to other parts of the body. Of course, the patient’s general health condition and age also play an important role. The treatment pathway for each patient requires a different strategy.

Early-Stage Cancers: If the cancer is detected at a very early stage, meaning only in the innermost layer of the stomach (mucosa), a major surgery may sometimes not be necessary. In this fortunate case, the cancerous area can be removed endoscopically, meaning with a camera inserted through the mouth, by scraping it from inside the stomach. This is a much more comfortable option in which the stomach is preserved.

Locally Advanced Cancers: This is the group in which surgery is performed most often. At this stage, the cancer has reached deeper layers of the stomach and/or spread to nearby lymph nodes, but has not yet spread to distant organs such as the liver or lungs. In today’s modern approach, these patients are usually not taken directly to surgery. First, they enter a preparation process called “neoadjuvant treatment.” In this process, the patient is given several cycles of chemotherapy before surgery (sometimes radiotherapy is also added). The goals of this treatment are:

• To shrink the tumor
• To make the surgery easier
• To increase the chance of success of the surgery
• To eliminate microscopic cancer cells that are not visible to the naked eye

After this pre-treatment is completed, stomach cancer surgery, which is the main treatment, is performed. At this stage, surgery is the most fundamental and indispensable step to achieve a cure.

Advanced-Stage (Metastatic) Cancers: If the cancer has spread to distant organs at the time of diagnosis (has metastasized), the goal of surgery changes. The aim is no longer to eliminate the cancer completely, but to improve the patient’s quality of life by resolving the problems caused by the cancer. This is called “palliative surgery.” For example, if there is a tumor blocking the gastric outlet and preventing the patient from eating, a bypass surgery can be performed to overcome this obstruction. Or if there is uncontrolled tumor bleeding, a surgical intervention may be required to control the bleeding. Such surgeries allow the patient to breathe a sigh of relief, to be able to eat, and to regain the strength to receive other treatments such as chemotherapy.

What Are the Risks of Stomach Cancer Surgery?

Stomach cancer surgery is a major and serious operation performed on an organ located at the center of the digestive system. Therefore, like any major surgical intervention, it carries its own risks. Knowing these risks helps the patient prepare for the process more consciously and also helps with early recognition of possible problems in the post-operative period. It is more accurate to examine these risks under two headings: general risks and risks specific to this surgery.

There are general risks that can be seen in all major abdominal surgeries.

• Infection at the wound site or inside the abdomen
• Bleeding during or after surgery
• Blood clots forming in the leg veins and traveling to the lungs (embolism)
• Undesired reactions related to anesthesia
• Inflammation of the lungs (pneumonia)
• Herniation or opening of the wound site

There are also risks more specific to this surgery, which are directly related to removal of the stomach and reconstruction of the digestive system. The most important ones are:

• Anastomotic leak: This is the most feared complication after this surgery. It is the leakage from the new connection (anastomosis) made between the esophagus and the small intestine after the stomach is removed. When detected early, it can usually be controlled with various methods, but if neglected, it can be life-threatening.
• Pancreas-related problems: The stomach is a very close neighbor to the pancreas. During surgery, especially while cleaning lymph nodes, the pancreas can be injured. This can lead to inflammation of the pancreas (pancreatitis) or leakage of pancreatic fluid into the abdomen (pancreatic fistula).
• Spleen injury: Especially in tumors in the upper part of the stomach, the vessels of the spleen are very close to the stomach. If an injury occurs to the spleen during surgery, the spleen may need to be removed. Living without a spleen is possible, but it can reduce the body’s resistance to certain infections.
• Chylous ascites (lymph leak): During extensive lymph node clearance, it is the leakage of a milky-white lymph fluid into the abdomen due to injury of one of the main lymphatic channels. It usually improves with a special diet and medication.

The frequency of these risks depends on many factors such as the experience of the surgical team, the hospital’s facilities, and the patient’s general health condition. Improving the patient’s nutritional status in the pre-operative period, quitting smoking, and doing breathing exercises contribute significantly to reducing these risks:

How Is Stomach Cancer Surgery Performed?

Stomach cancer surgery is a multi-stage process that requires meticulous planning and precise execution. Success depends not only on performance during the operation, but also on preparation beforehand and follow-up afterward.

Pre-Operative Preparation Period

This period is the most critical stage in which the roadmap is drawn. A series of tests are performed to understand the status of the disease. These tests include:

• Computed Tomography (CT)
• Endoscopy and Biopsy
• Endoscopic Ultrasound (EUS)
• PET-CT (in cases deemed necessary)
• Diagnostic Laparoscopy (if intra-abdominal spread is suspected)

Based on these results, the stage of the disease is determined and the treatment plan is clarified. In addition, the patient’s general condition is evaluated. If there is weight loss, nutritional support is provided before surgery to strengthen the patient. If the patient smokes, they are asked to quit, and breathing exercises are taught. Thanks to modern surgical protocols called “ERAS,” patients are prepared for surgery in the best possible way both physically and mentally.

Technical Stages of the Surgery

The surgery is performed under general anesthesia. The surgeon may perform the operation using one of three different methods.

• Open Surgery: The traditional method performed by making a vertical incision in the abdominal wall.
• Laparoscopic Surgery (Closed Method): A modern method performed through a few small openings in the abdomen with the help of a camera and thin instruments.
• Robotic Surgery: The most technologically advanced version of laparoscopic surgery, in which the surgeon controls robotic arms via a console.

The greatest advantages of closed and robotic methods are that they allow the patient to have a more comfortable post-operative period. These advantages are:

• Less post-operative pain
• Smaller scar
• Lower risk of infection
• Faster return of bowel movements
• Shorter hospital stay
• Faster return to daily life

The most important point to remember here is this: Regardless of which method is chosen, the oncologic clearance principles applied inside never change. What matters most is not the instrument or technology, but the surgeon’s experience and competence with these methods.

Inside the operation, essentially three procedures are performed. First, depending on the location and size of the tumor, part of the stomach (subtotal gastrectomy) or all of it (total gastrectomy) is removed. The second and most critical stage is lymph node clearance called “D2 lymphadenectomy.” This is the meticulous removal not only of nodes attached to the stomach, but also of all potential cancer spread stations around the main vessels supplying the stomach. In the final stage, continuity of the digestive system is ensured. If the entire stomach has been removed, the esophagus; if part has been removed, the remaining part of the stomach is reconnected to the small intestine with special techniques.

Post-Operative Process After Stomach Cancer Surgery

When the surgery is completed, the patient’s recovery and adaptation process to their new life begins. This process requires patience and care at least as much as the surgery itself.

The First Days in the Hospital

The first few days after surgery are usually spent under close monitoring. In this period, there are basic practices implemented to ensure the patient’s comfort and accelerate recovery:

• Effective pain control
• Early mobilization and walking
• Breathing exercises to keep the lungs clear
• Intravenous nutrition until bowel movements start
• Gradual transition to liquid foods depending on the situation
• Removal of abdominal drains and tubes

Thanks to modern surgical approaches (ERAS protocols), patients recover much faster than before and hospital stays have become shorter.

Pathology Report and the Future Plan

All tissues removed during surgery are examined in detail in the pathology laboratory. This examination takes approximately 7–10 days. The resulting report is like a roadmap for the future of treatment. It contains vital information such as the type of tumor, how deeply it has invaded, how many of the removed lymph nodes contain cancer, and whether the surgical margins are clear. Based on this information, the definitive stage of the disease is determined, and together with the oncologist, a decision is made about whether additional post-operative chemotherapy or another treatment is needed.

Discharge and Recovery at Home

Patients are usually discharged after their condition stabilizes and they begin to tolerate oral nutrition. The process at home is a slow and gradual adaptation period. Feeling tired and weak in the first few weeks is normal. During this period, it is important to avoid heavy lifting, eat as recommended by the doctor, and gradually increase activity with short walks. The full recovery period varies from person to person and may take several months.

What Those Who Have Undergone Stomach Cancer Surgery Should Pay Attention to

Removal of part or all of the stomach creates permanent changes in digestive physiology. Therefore, life after surgery brings some new rules and habits. Adapting to these rules is indispensable for the patient to protect their long-term health and maintain a high quality of life.

Nutrition: A New Lifestyle

The biggest change is undoubtedly in eating habits. Since the stomach’s storage and grinding functions are no longer present, the digestive system needs support. The main rules are:

• Eating 6–8 small meals a day instead of 3 large meals
• Not consuming liquids during meals (taking liquids 30 minutes before or after meals)
• Chewing every bite very well
• Choosing high-nutritional-value, protein-rich foods
• Eliminating simple sugars such as sugar, honey, jam, and sugary drinks from daily life

Dumping Syndrome: A Condition That Must Be Known and Managed

This is the most common and most challenging condition for patients after stomach surgery. It occurs as a result of food passing too quickly and uncontrollably from the stomach into the small intestine. It can present in two different ways.

Early dumping symptoms usually appear immediately after eating.

• Sudden abdominal cramps and bloating
• Nausea and diarrhea
• Cold sweating
• Severe palpitations
• Dizziness and a feeling of faintness

Late dumping symptoms occur 1–3 hours after eating.

• Sudden weakness and exhaustion
• Trembling
• Cold sweating
• Mental fog
• Severe hunger

Although dumping syndrome can be frightening, it can be controlled to a large extent by following the nutrition rules mentioned above.

Lifelong Vitamin and Mineral Supplementation

The stomach is an indispensable organ for the absorption of some critical vitamins and minerals. When the stomach is removed, this absorption is impaired, and supplementation becomes mandatory. These supplements must be continued for life.

• Vitamin B12: Since absorption stops completely, it should be taken regularly as injections or in high-dose sublingual tablet form.
• Iron: Anemia due to deficiency is common and requires iron supplementation.
• Calcium: It is critical for bone health.
• Vitamin D: It is required for calcium absorption.

Regular Doctor Check-Ups

After surgery, patients are closely followed according to a schedule determined by the surgeon and oncology doctors. In these follow-ups, blood tests and, if necessary, imaging methods are used both to check the body’s vitamin-mineral stores and to investigate whether the disease has recurred. Not missing these check-ups is one of the most important steps for a long and healthy life.