Randomized clinical trial of splenectomy versus splenic preservation in patients with proximal gastric cancer

Background: Preservation or removal of the spleen during total gastrectomy for proximal gastric cancer is a matter of debate. Methods: A randomized clinical trial included patients with gastric adenocarcinoma who underwent total gastrectomy either with (104 patients) or without (103) splenectomy. Po...

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Bibliographic Details
Published in:British journal of surgery 2006-05, Vol.93 (5), p.559-563
Main Authors: Yu, W., Choi, G. S., Chung, H. Y.
Format: Article
Language:English
Subjects:
Adenocarcinoma - surgery
Adult
Aged
Biological and medical sciences
Female
Gastrectomy - methods
General aspects
Humans
Liver, biliary tract, pancreas, portal circulation, spleen
Lymphatic Metastasis - prevention & control
Male
Medical sciences
Middle Aged
Spleen
Splenectomy - adverse effects
Stomach Neoplasms - surgery
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the digestive system
Survival Analysis
Treatment Outcome
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Summary:Background: Preservation or removal of the spleen during total gastrectomy for proximal gastric cancer is a matter of debate. Methods: A randomized clinical trial included patients with gastric adenocarcinoma who underwent total gastrectomy either with (104 patients) or without (103) splenectomy. Postoperative outcome in the two groups was compared, including morbidity, mortality and survival. Results: Gastrectomy combined with splenectomy tended to be associated with slightly higher morbidity and mortality rates, a slightly greater incidence of lymph node metastasis at the splenic hilum and along the splenic artery, and marginally better survival, but there were no statistically significant differences between the groups. Splenectomy had no impact on survival in patients with metastatic lymph nodes at the hilum of the spleen or in those with metastatic lymph nodes along the splenic artery. Conclusion: These results do not support the use of prophylactic splenectomy to remove macroscopically negative lymph nodes near the spleen in patients undergoing total gastrectomy for proximal gastric cancer. Copyright © 2006 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. Splenectomy has no advantages
ISSN:0007-1323
1365-2168
DOI:10.1002/bjs.5353