Review of Splenectomy, Pancreas-preserving Splenectomy, Pancreatosplenectomy for Combined Radical Total Gastrectomy.
- Author:
Gun Sik MIN
1
;
Jin Woo CHA
;
Ji Hoon KIM
;
Yong Kwan CHO
;
Sang Uk HAN
;
Myung Wook KIM
Author Information
1. Department of Surgery, Ajou University School of Medicine, Suwon, Korea. choyk@ajou.ac.kr
- Publication Type:Original Article
- Keywords:
Gastric cancer;
Total gastrectomy;
Pancreas- preserving splenectomy
- MeSH:
Diabetes Mellitus;
Gastrectomy*;
Humans;
Lymph Nodes;
Neoplasm Metastasis;
Splenectomy*;
Splenic Vein;
Stomach Neoplasms;
Survival Rate
- From:Journal of the Korean Surgical Society
2002;63(5):397-402
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Splenectomy, pancreas-preserving splenectomy, pancreato-splenectomy are common combined operations of a total gastrectomy for gastric cancer. We attempted to determine the efficacy of these procedures after comparing and analyzing the complication rate and the five-year survival rate from the gastric cancer patients. METHODS: 121 advanced gastric cancer patients, except T4 patients, underwent radical total gastrectomy accompanied with splenectomy. and analyzed the clinical findings eg. age, sex, location of tumor, histological differentiation, lymph node metastasis, number of dissected LN, complication and the 5-year survival rate. RESULTS: 44 out of 121 patients underwent a pancreato- splencetomy, 53 patients underwent a pancreas-preserving splenectomy, and 24 patients underwent a simple splenectomy. There were no statistical difference in the patient's age, sex, location of tumor, histological differentiation, lymph node metastasis, the number of dissected LN and the 5 year-survival rate in stage II, IV with each operation. However, a pancreas-preserving splenectomy showed a better 5-year survival rate (53.7%) than a simple splenectomy (25.0%) and pancreato-splenectomy (32.1%) in stage III. The complication rate was 25% in a simple splenectomy, 17% in a pancreas-preserving splenectomy, 30% in a pancreato- splenectomy. Diabetes mellitus occurred in 3 patients who underwent a pancreato-splenectomy, in 1 patient with an iatrogenic splenic vein excision during a pancreas-preserving splenectomy. CONCLUSION: A pancreas-preserving splenectomy is the best choice in stage IIIa total gastrectomy patients with the lowest complication rate.
