Stomach cancer surgery (Surgery for gastric (stomach) cancer)
An overview of the operations used to treat stomach (gastric) cancer, from removing very early cancers through to removing part or all of the stomach, as part of a wider specialist treatment plan.
✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review
In short
- Stomach cancer surgery ranges from removing very early cancers through a telescope to removing part or all of the stomach, depending on where the cancer is and its stage.
- It is usually one part of a plan that includes staging, a multidisciplinary team decision and often chemotherapy before and after surgery; it does not by itself guarantee a cure.
- Removing the stomach is major surgery with a long recovery and lasting changes to eating; sometimes surgery is used to relieve symptoms rather than to cure.
- This is normally done within the NHS by a specialist team; ask which operation is planned, what the staging shows, and what the multidisciplinary team has recommended.
A plain-English summary. The detail — including risks and recovery — is below.
At a glance
A general guide. Your surgeon will give you advice for your situation.
Removes the cancer and, in gastrectomy, the nearby lymph nodes so they can be examined.
The cancer has spread beyond what surgery can remove, so a non-surgical plan may be more appropriate.
Often a day case or short stay, with a quick return to normal activity and advice on diet and any follow-up endoscopy.
A named specialist nurse and a clear contact route for problems after discharge.
Often a day case or short stay, with a quick return to normal activity and advice on diet and any follow-up...
You are helped to sit up, do breathing exercises and start moving, with drips, drains and sometimes a feeding tube...
A dietitian helps you build up from fluids. Most people go home around 10 days to 2 weeks, depending on progress...
UK guidance suggests it usually takes 4 to 6 weeks to build up to solid foods, eaten little and often. Driving is...
What is stomach cancer surgery?
Stomach cancer surgery means an operation to remove cancer in the stomach. The type depends mainly on where the cancer is and its stage. Very early, superficial cancers can sometimes be removed from the lining using a telescope (endoscopic resection). More commonly, surgery means removing part of the stomach (partial or subtotal gastrectomy) or the whole stomach (total gastrectomy), together with nearby lymph nodes.
Surgery is usually only one part of treatment. A multidisciplinary team (MDT) decides the plan after staging scans, and many people have chemotherapy before and after surgery. The removed tissue is examined to give an accurate (pathological) stage, including whether the edges are clear of cancer (the margins) and how many lymph nodes are involved.
For cancer that has not spread, surgery offers the best chance of long-term control, but it cannot on its own guarantee a cure. Where the cancer cannot be fully removed, an operation may still be used to relieve symptoms such as a blockage, rather than to cure.
This guide gives an overview; your team will explain exactly which operation is being recommended and why.
Types & techniques
There isn't one single operation. The right approach depends on you — which is something to discuss with your surgeon.
Endoscopic resection versus gastrectomy
| Point | Endoscopic | Gastrectomy |
|---|---|---|
| Used for | Very early surface cancer | Most other operable cancers |
| How | Telescope via the mouth | Open or keyhole surgery |
| Stomach removed | None | Part or all |
| Stay | Day case or short | About 10 days to 2 weeks |
| Recovery | Quick | Long, up to a year |
Endoscopic resection only suits selected very early cancers. Most stomach cancers needing surgery require removal of part or all of the stomach. Your team will explain which applies to you.
Preparing for your surgery
- You will have staging scans (such as CT, sometimes PET-CT) and, for potentially curable gastric cancer, often a staging laparoscopy; a multidisciplinary team (MDT) agrees the plan.
- Many people have chemotherapy before and after surgery; ask how this fits with the timing of your operation.
- You will usually have fitness checks because gastrectomy is demanding surgery.
- Stop smoking as early as possible and ask about prehabilitation to improve nutrition, activity and breathing before surgery.
- Tell the team about all your medicines, especially blood thinners, and about diabetes, alcohol use and other conditions.
- Plan for a long recovery if you are having part or all of your stomach removed, with help at home.
- Ask whether you will need vitamin B12 or other supplements after surgery.
What happens
What happens depends on the operation. Endoscopic resection is done with sedation through a telescope passed via the mouth, often as a day case or short stay.
A gastrectomy is done under general anaesthetic and can take roughly 3 to 8 hours. The surgeon makes either larger cuts (open surgery) or several small cuts (keyhole or robot-assisted surgery), removes part or all of the stomach with nearby lymph nodes, and reconnects the digestive system.
After a gastrectomy you are likely to have drips, drains and sometimes a feeding tube while you heal, and nurses and physiotherapists help you move and do breathing exercises early. Most people stay around 10 days to 2 weeks.
The removed tissue is examined over the following weeks to give the pathological stage, which guides any further treatment.
Is this operation right for me?
A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.
May not be suitable if…
- The cancer has spread beyond what surgery can remove, so a non-surgical plan may be more appropriate.
- You are not fit enough for major surgery and a long recovery, based on overall assessment.
- Your nutrition is very poor and needs improving before surgery could be considered.
- Endoscopic resection is not suitable because the cancer is too deep or advanced.
- A multidisciplinary team judges that the risks outweigh the likely benefit for your situation.
Delay surgery if…
- You have an active infection or are acutely unwell.
- Your nutrition or fitness can be improved first with prehabilitation.
- Planned chemotherapy before surgery is not yet complete.
- Important staging results, such as a staging laparoscopy, are still awaited.
- Your blood-thinning or other medication needs adjusting before surgery.
Alternatives to discuss
- Endoscopic resection for very early, superficial cancers instead of gastrectomy.
- Chemotherapy, immunotherapy or targeted treatment for cancer that has spread.
- Surgery, a stent or a bypass to relieve a blockage when the cancer cannot be fully removed.
- Definitive non-surgical treatment where surgery is too risky.
- Best supportive (palliative) care focused on symptoms and quality of life.
Before you decide
Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.
What matters most to me?
Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.
What are all my options?
Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.
What would make me pause?
Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.
What happens if I do nothing today?
For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.
Anaesthetic choices
The safest option depends on the operation, your health, the facility and your surgeon/anaesthetist. Ask what is planned and why.
Benefits
- Removes the cancer and, in gastrectomy, the nearby lymph nodes so they can be examined.
- Offers the best chance of long-term control or cure for cancer that has not spread.
- Provides accurate (pathological) staging, including the margins and lymph node involvement.
- Endoscopic resection can treat some very early cancers without major surgery.
- Can relieve symptoms such as a blockage when cure is not possible.
Risks & complications
- After gastrectomy: pain, tiredness, a long recovery and weight loss.
- Eating in smaller, more frequent meals and feeling full quickly.
- Dumping syndrome: feeling sweaty, faint, sick or having loose stools soon after eating.
- After endoscopic resection: usually milder, such as some discomfort or a small risk of bleeding.
- A leak where the digestive system is rejoined (anastomotic leak) after gastrectomy.
- Chest infection or pneumonia after major surgery.
- Blood clots, bleeding or wound infection.
- Bleeding or a small tear (perforation) after endoscopic resection.
- Vitamin and mineral deficiencies, including the need for vitamin B12 after a total gastrectomy.
- Need to return to theatre for a serious complication after gastrectomy.
- Damage to nearby organs during surgery.
- Life-threatening complications; gastrectomy is major surgery and a small number of people do not survive the operation or its early complications.
Risks depend heavily on the operation. Endoscopic resection is generally lower risk than gastrectomy. UK patient information notes that up to around half of people having stomach removal develop some complication, which can lengthen the stay; most are managed, but some are serious. Results tend to be better in high-volume specialist centres, so ask how many of these operations the unit does and what their figures are.
Published figures to discuss
Risk and outcome figures vary a great deal with the type of operation, the stage of the cancer, your fitness and how many of these operations the centre performs. Endoscopic resection is generally lower risk than gastrectomy. UK audit data show outcomes from cancer surgery have improved over time and tend to be better in higher-volume specialist units. The figures below are cautious indicators, not personal predictions.
| Figure | Reported range | How to interpret it | Source / confidence |
|---|---|---|---|
| Developing some complication after gastrectomy | Up to around half in UK patient information; recent total-gastrectomy series report about 40–45% within 90 days | Many are minor and managed, but some are serious. Complications can lengthen the hospital stay. | Anastomotic leakage after gastrectomy in 3,926 patients — Frontiers in Oncologyfrontiersin.orgPublished figure |
| Leak at the join after gastrectomy | Usually about 1–6% after gastrectomy, higher in total, proximal or complex cases | Can often be treated with drainage, endoscopic treatment and nutrition support, but may need further surgery. | Anastomotic leakage after gastrectomy in 3,926 patients — Frontiers in Oncologyfrontiersin.orgPublished figure |
| Death around the time of major surgery | UK NOGCA overall curative OG surgery: about 1.3% at 30 days and 2.7% at 90 days in 2019–20 | Total gastrectomy series often report 30-day mortality around 2% and 90-day around 3–4%; risk is higher with frailty, malnutrition and complications. | Anastomotic leakage after gastrectomy in 3,926 patients — Frontiers in Oncologyfrontiersin.orgPublished figure |
These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.
Recovery — what to expect, and when
Recovery depends on the operation. Endoscopic resection often involves only a short recovery, while a gastrectomy is a long recovery: most people stay around 10 days to 2 weeks, and full recovery can take up to a year.
- After gastrectomy: eating much smaller amounts and feeling full quickly.
- Weight loss in the early weeks before things stabilise.
- Dumping symptoms after meals, which often improve with dietary changes.
- Tiredness that can last weeks to months after major surgery.
- After endoscopic resection: usually little disruption, with normal eating resuming quickly.
Aftercare
- Follow the dietitian's plan after gastrectomy: eat little and often, chew well and avoid large drinks with meals.
- Take prescribed supplements, including vitamin B12 injections if advised after a total gastrectomy.
- Sit upright after eating and avoid lying down straight away to reduce reflux.
- Build up activity gradually and avoid heavy lifting for at least 6 weeks after major surgery.
- Watch your weight and report ongoing loss, difficulty swallowing or persistent vomiting.
- Attend any planned follow-up endoscopy after endoscopic resection.
- Keep all follow-up appointments and know who to contact with problems.
- A clear understanding of which operation you are having and what recovery to expect.
- Dietitian contact and an eating plan if you are having a gastrectomy.
- Any supplements, including vitamin B12, arranged if needed.
- Someone to help at home for the first few weeks after major surgery.
- Pain relief and any medicines collected.
- Specialist nurse or unit contact number for problems.
- Follow-up and results appointments noted.
Scars and how they heal
Endoscopic resection leaves no external scars as it is done through the mouth. A gastrectomy leaves surgical scars on the tummy whose number and size depend on whether open or keyhole surgery is used; these are firm and pink at first and usually fade over months.
⚠ Get urgent help if…
- Fever, increasing tummy pain or feeling very unwell, which can signal infection or a leak.
- Breathlessness or chest pain, which need urgent assessment.
- A hot, swollen, painful calf or sudden breathlessness, which can mean a blood clot.
- Vomiting blood or passing black, tarry stools.
- Persistent vomiting or being unable to keep fluids down.
- Wound redness, swelling or discharge after surgery.
- Dizziness or fainting, rapid weight loss or signs of dehydration.
Who to contact: your surgeon or clinic first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.
General guidance — it doesn't replace the specific advice your surgeon gives you.
Results & realistic expectations
A good result means the cancer has been removed, ideally with clear margins (no cancer at the cut edges), and in gastrectomy that the lymph nodes have been examined. The pathological stage is usually clearer after surgery than from scans alone and guides whether further treatment is advised.
Surgery cannot guarantee that cancer will not return. The outlook depends on the type and stage of the cancer, the margins and lymph node involvement, and any further treatment, which is why ongoing follow-up matters.
How durable the result is depends on the type and stage of the cancer, the margins, lymph node involvement and any further treatment. Even after a successful operation, cancer can sometimes return, so people are followed up over years. After removal of part or all of the stomach, eating changes are usually permanent, and after a total gastrectomy vitamin B12 injections are needed for life.
Combining with other procedures
Stomach cancer surgery is usually combined with chemotherapy before and after surgery, staging investigations such as a staging laparoscopy, and dietitian support. Some cancers also involve targeted treatment (for example where the cancer is HER2-positive) or other treatments. Decisions are made by a multidisciplinary team rather than a single doctor.
Follow-up & long-term care
After surgery you will be reviewed to check healing and eating, discuss the pathology results and plan any further treatment. Follow-up for cancer typically continues at regular intervals over several years to look for signs of recurrence and to support nutrition, including monitoring for vitamin and mineral deficiencies.
- Lifelong vitamin B12 injections after a total gastrectomy, and possibly after a partial gastrectomy.
- Attention to eating little and often, with dietitian input as needed.
- Monitoring and treatment of other vitamin or mineral deficiencies if they develop.
- Regular cancer follow-up appointments and scans as advised.
- Follow-up endoscopy after endoscopic resection where recommended.
Revision and secondary surgery reality
- Some people need a further procedure for a complication, such as draining a leak or returning to theatre.
- Endoscopic resection may need to be repeated or followed by surgery if the cancer is deeper than expected.
- Further cancer treatment may be advised after surgery depending on the pathology results.
- Eating, weight and supplement needs often require ongoing dietitian and medical review after gastrectomy.
Ask your surgeon for their own revision rate, what counts as a revision, and what is included in the written aftercare policy.
What good aftercare looks like
- A named specialist nurse and a clear contact route for problems after discharge.
- Structured dietitian support after gastrectomy to build up eating, manage dumping and protect weight.
- A clear plan for vitamin B12 and other supplements where needed.
- A clear plan for results, further treatment and long-term cancer follow-up.
- Quick access back to the surgical team if a complication is suspected.
What affects the cost
Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:
- The type of operation (endoscopic resection versus partial or total gastrectomy).
- The surgeon's and assisting team's fees.
- Anaesthetic and any high-dependency or intensive care after major surgery.
- Theatre time and the length of the hospital stay.
- Investigations and staging, and any chemotherapy or targeted treatment in the wider plan.
- Dietitian, specialist nurse and follow-up care, including any vitamin B12 injections.
- The cost of managing any complications, which can extend the stay.
- Which operation is included and the surgeon's and team's fees.
- Anaesthetic fees and the cost of any high-dependency or intensive care.
- The hospital/theatre fee and an estimate for the length of stay.
- Whether staging investigations, chemotherapy or targeted treatment are included or separate.
- Dietitian, specialist nurse and follow-up appointments.
- What happens, and who pays, if a complication needs extra treatment or a longer stay.
- How further treatment is arranged once pathology results are known.
On the NHS? Surgery for stomach cancer is normally provided on the NHS through a specialist oesophago-gastric team; private care may be used for speed of assessment, choice of consultant or a second opinion.
You're entitled to your total cost in writing — including aftercare and any revision — before you decide.
Consent traps and marketing red flags
These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.
Consent traps
- Being given a sense that surgery alone guarantees a cure, without discussion of stage, recurrence risk and further treatment.
- Not explaining which operation is planned and why, or the difference between curative and symptom-relieving surgery.
- Not discussing the serious risks of major surgery and the lasting changes to eating.
- No clear plan for nutrition support, supplements or what happens if there is a complication.
- Not discussing alternatives such as endoscopic resection for very early cancers.
Marketing red flags
- Any claim of a guaranteed cure or being 'cancer-free' from surgery alone.
- Promoting keyhole or robotic surgery as without risks or much safer rather than an alternative approach with similar serious risks.
- Downplaying the recovery, the chance of complications or the lifelong changes after stomach removal.
- Pressure to decide quickly without a multidisciplinary team plan or a second opinion.
Choosing a surgeon safely
- Check your surgeon is on the GMC Specialist Register for this area.
- Make sure they practise at a CQC-registered location, and look for membership of bodies like BAAPS or BAPRAS.
- You're entitled to a two-stage consent process with time to reflect (a cooling-off period). The surgeon who will operate must consent you — not a salesperson.
- Be wary of pressure: time-limited offers, discounts or deposits taken before you've had time to think are red flags, not bargains.
- You're entitled to your total cost in writing — including aftercare and any revision — before you decide.
Questions to ask your medical professional
Take this to your consultation. A good surgeon will welcome every one of these.
- Which operation are you recommending for me, and why?
- What does my staging show, and is the aim to cure or to control the cancer?
- Has my case been discussed by a multidisciplinary team?
- What further treatment, such as chemotherapy, is planned before or after surgery?
- How many of these operations do you and this unit do each year, and what are your results?
- How will my eating change, and what support and supplements will I need?
- What follow-up will I have, and what happens if the cancer comes back?
- Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
- Will you be the surgeon who carries out my operation, and who looks after me afterwards?
- What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
- What does a realistic result look like — and what can this operation not achieve?
- What are my options, including waiting, doing nothing for now, or choosing a different approach?
- Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
- What is the total cost in writing, including any follow-ups, and how much time do I have to decide?
Frequently asked questions
Is stomach cancer surgery available on the NHS?
Will surgery cure my stomach cancer?
Can my cancer be removed through a telescope?
Will I have to have my whole stomach removed?
Why do I need chemotherapy as well as surgery?
What if my cancer cannot be removed?
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How we made this page
Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →
Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.
Sources & standards: NHS — Treatment for stomach cancer Cancer Research UK — Types of surgery for stomach cancer NHS — Gastrectomy NICE NG83 — Oesophago-gastric cancer: assessment and management NICE NG83 — Information for the public National Oesophago-Gastric Cancer Audit (NATCAN) NOGCA 2012–2020 analysis of oesophago-gastric cancer surgery outcomes — BJS Anastomotic leakage after gastrectomy in 3,926 patients — Frontiers in Oncology Morbidity and mortality of total gastrectomy — PubMed
Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.
Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.
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