Stomach cancer surgery represents the primary curative treatment modality for resectable gastric adenocarcinoma. The core mechanism involves removing the stomach segment containing the tumor, adjacent unaffected tissue margins, and local lymphatic drainage pathways (D2 lymphadenectomy). The medical category is surgical oncology, specifically upper gastrointestinal surgical oncology. Reconstructive methods, such as Roux-en-Y gastrojejunostomy or esophagojejunostomy, restore digestive continuity after resection.

1. Administration of general anesthesia and insertion of intravenous, arterial, and bladder catheters.
2. Surgical entry via open midline laparotomy, multi-port laparoscopy, or robotic surgical platform.
3. Thorough abdominal exploration to rule out peritoneal carcinomatosis or liver metastasis.
4. Mobilization of the stomach by dissecting the greater and lesser omentum.
5. Ligation and division of left and right gastric, left and right gastroepiploic, and short gastric blood vessels.
6. Systematic D2 lymph node dissection, including nodal stations along the celiac axis, hepatic artery, splenic artery, and gastric curvature.
7. Transection and resection of the designated stomach portion (subtotal, distal, proximal, or total gastrectomy) with clear surgical margins.
8. Digestive tract reconstruction utilizing Roux-en-Y esophagojejunostomy, Roux-en-Y gastrojejunostomy, or Billroth II bypass.
9. Intraoperative leak testing and placement of surgical drains if indicated.
10. Layered closure of abdominal incisions and application of sterile dressings.

The primary benefit of stomach cancer surgery is the potential for complete oncological cure in early and locoregionally advanced disease. Surgical resection achieves local disease control, alleviates tumor-related upper gastrointestinal bleeding or luminal obstruction, provides definitive histological staging, and significantly improves long-term survival when combined with modern multimodal cancer therapies.

Short-term recovery occurs in the hospital over 7 to 10 days, focusing on early ambulation, pain management, and step-wise dietary escalation from clear liquids to soft foods. Long-term recovery spans 3 to 12 months, during which patients adjust to smaller meal capacities, learn to manage dumping syndrome symptoms, and receive routine nutritional monitoring, including parenteral vitamin B12 administration.

Stomach cancer surgery is indicated for malignant conditions of the stomach, primarily gastric adenocarcinoma (including intestinal and diffuse subtypes according to the Laurén classification). It is also utilized for gastrointestinal stromal tumors (GISTs) with high risk features, primary gastric lymphomas unresponsive to medical management, gastric neuroendocrine tumors (NETs), and severe refractory gastric dysplasia requiring definitive resection.

1. Comprehensive pre-treatment staging including contrast CT of abdomen/chest, upper endoscopy with biopsy, and diagnostic laparoscopy when indicated.
2. Cardiopulmonary clearance including electrocardiogram, echocardiogram, and pulmonary function testing.
3. Preoperative nutritional optimization, high-protein oral nutritional supplements, and treatment of baseline anemia.
4. Cessation of smoking and alcohol consumption at least 4 weeks prior to surgery.
5. Medication review with temporary discontinuation of antiplatelet agents and anticoagulants under clinical guidance.
6. Pre-habilitation exercise programs to improve functional respiratory and physical reserve.
7. Standard preoperative fasting starting midnight prior to the procedure.

1. Common/Mild: Surgical site incisional pain, transient nausea, delayed gastric emptying, minor wound bruising, early satiety.
2. Uncommon/Moderate: Superficial surgical wound infection, postoperative ileus, localized intra-abdominal fluid collection, persistent dumping syndrome, deep vein thrombosis.
3. Rare/Severe: Anastomotic leakage, severe intra-abdominal hemorrhage, pancreatic fistula, pulmonary embolism, sepsis, perioperative mortality.

The clinical patient journey begins with diagnostic staging using upper gastrointestinal endoscopy, endoscopic ultrasound, and contrast-enhanced computed tomography. Following multidisciplinary tumor board review, eligible patients may receive neoadjuvant systemic therapy before entering the surgical phase. The inpatient operation lasts 3 to 5 hours, followed by 7 to 10 days of hospital care involving monitored oral refeeding and pain control. Post-discharge recovery extends over 3 to 6 months, featuring structured dietary adaptation, histological reporting, and adjuvant therapy planning.