Problems after surgery for stomach cancer

Risks after surgery

After any major operation there is a risk of: 

Infection

You are at risk of getting an infection after an operation. This includes a wound, chest or urine infection. Symptoms can depend on where the infection is. Tell your doctor or nurse if you have any symptoms of infection.

These include:

• a high temperature

• shivering

• feeling hot and cold

• feeling generally unwell

• cough

• feeling sick

• swelling or redness around your wound and your wound might feel hot

• a strong smell or liquid oozing from your wound

• loss of appetite

• cloudy smelly pee

If you get an infection, your doctor gives you antibiotics to treat it.

Sometimes for an infection in your wound, you may need another operation. But this is rare.

Blood clots

Blood clots are also called a deep vein thrombosis or DVT. They are a possible complication of having surgery because you might not move about as much as usual. Clots can block the normal flow of blood through the veins. Let your doctor or nurse know if you have an area in your leg that is swollen, hot, red or sore.

There is a risk that a blood clot can become loose and travel through the bloodstream to the lungs. This causes a blockage called a pulmonary embolism. Symptoms include:

• shortness of breath

• chest pain

• coughing up blood

• feeling dizzy or lightheaded

To prevent clots it's important to do the leg exercises that your nurse or ​physiotherapist​ taught you. And to move around as much as possible. Your nurse might also give you an injection just under the skin to help lower the risk whilst you are in hospital. You might need to carry on having these injections for a few weeks, even after you go home. This depends on the type of operation you had.

Your nurse might teach you to do these injections yourself before you go home. They will make sure you are comfortable doing them. Or a district nurse might come to your home to do them.

It's important to continue wearing your anti embolism stockings if you have been told to by your doctor. 

Chest and breathing problems

Chest infections, including pneumonia, can be serious. 

You can lower your risk by:

• stopping smoking before your operation

• getting up and moving as soon as possible after your operation

• doing any breathing exercises your physiotherapist teaches you

If you get an infection, you have antibiotics to treat it. 

Bleeding

There is a risk that you might bleed after your operation while still in hospital. The team looking after you will monitor you closely for signs of bleeding. The treatment you need depends on what is causing the bleeding and how much blood you lose. If you lose a lot of blood you might need a ​blood transfusion​ or may need a further operation to stop the bleeding.  

At home, if you think you look paler than normal, or you continue to feel tired, speak to your doctor or specialist nurse (CNS). They may arrange a blood test to see if your ​red blood cell​ level is low.

Other risks

There are some other complications that can happen after stomach cancer surgery. Your team will keep a close eye on you to look out for these problems. 

A leak where the stomach joins the small bowel

Leaks can happen where the surgeon joins the end of the stomach or food pipe (oesophagus) and the small bowel. This is called an anastomotic leak. This is a serious problem and you need to have treatment straight away.

Treatment includes:

• stopping eating and drinking

• antibiotics

• draining the leak

• tube feeding

You will have endoscopies and scans to check that it is healing. You might need more surgery to repair the leak if the other treatments don’t work. You need to stay in hospital longer if you have a leak.

Heart problems

Some people have heart problems after this surgery. This can cause problems with other organs, including your kidneys. You’ll have regular blood tests to check how well your heart and kidneys work.  

Thoracic duct or chyle leak

The thoracic duct is a tube close to the oesophagus. It is part of the lymphatic system. If you have an oesophagogastrectomy, your surgeon may divide it. Rarely, it leaks after your operation. This is most likely to happen in the first week after surgery.

The main symptom is more fluid draining into your chest drain than your doctor would expect.

Rarer symptoms include pain and feeling breathless.

Treatment is to drain the fluid. You might need to have another tube put into the area where the fluid is collecting. You might need to have an operation to repair it if the duct doesn’t repair itself.

Contact your doctor if you have any symptoms.

Problems after you go home

Some complications might cause you problems after you go home. You will have regular follow up appointments with your surgeon. They will check whether you have any problems.  

Contact your doctor or specialist nurse if you have any concerns between appointments. You don’t have to wait until your next visit.

Weakness and lacking strength

Surgery for stomach cancer is a major operation.

Most people feel weak and lack strength for some time afterwards. How long this lasts will vary.

Tell your doctor or nurse if the weakness continues for more than a few weeks. They can suggest things to help, such as physiotherapy.

Eating problems

Most people have some problems eating after surgery. This can cause weight loss. Many people don’t regain their weight easily. Eating small amounts regularly is important.

You might also have tummy (abdominal) discomfort and diarrhoea after certain foods. The combination of these symptoms is called dumping syndrome.

Follow all of the instructions the dietitian gives you. Tell your dietitian about any problems you have with eating.

Slow emptying of your stomach and reflux

Surgery can cause a problem with the contents of the stomach going back into the food pipe (reflux).

Reflux can cause symptoms such as heartburn. Treatment includes:

• antacids

• medicines that help to move food through the stomach and bowel

Not getting enough nutrients

After stomach surgery you may need to take extra calcium, vitamin D and iron. This is because the stomach absorbs these nutrients. You can’t absorb enough from your normal diet without all or most of your stomach.

You will no longer be able to take in vitamin B12 from your food without most or all of your stomach. This is because your stomach produces a substance called intrinsic factor that means your body can use vitamin B12. Vitamin B12 helps us maintain a healthy blood supply. You will need vitamin B12 injections.

Go to more information about eating problems with stomach cancer