constructed. With a total gastrectomy, 5 to 15 percent of patients may not survive the operation and there may be significant complications. One major complication is that the connection constructed during the esophagojejunostomy may break down. The surgical margin should be greater than 21/2 in. (6 cm) beyond the gross tumor . (A frozen section should be done to confirm that the margin has no cancer.)
When extensive surgery for cure is impractical or impossible, part of the stomach might still be removed as a palliative measure. Sometimes the tumor causes recurrent bleeding or becomes so large that it obstructs the gastrointestinal tract and causes nausea, vomiting or stomach distention. A partial gastrectomy can temporarily improve the quality of life, although total gastrectomies have a high rate of complications and have little benefit when all the tumor cannot be removed. If up to four liver metastases are found by CT or at surgery, they are sometimes removed.
