Study of influence of splenectomy on surgical efficacy in patients with gastric cancer in upper and middle portion and entire stomach / 重庆医学

ABSTRACT

Objective To study the influence of splenectomy on the surgical efficacy in the patients with gastric cancer in the up-per and middle portion and entire stomach .Methods 86 patients with gastric cancer in the upper and middle portion and entire stomach receiving the gastric cancer D 2 radical operation in the two hospitals from April 2003 to January 2008 were selected and di-vided into the observation group(47 cases) and the control group(39 cases) .The observation group accepted the modified lymph-adenectomy with spleen-preserving ,while the control group accepted the D2 total radical gastrectomy with splenectomy .The long-term effects were compared between the two groups .Results The total hospitalization time and the occurrence rate of postoperative complications were(20 .62 ± 7 .93)d and 10 .64% in the observation group ,which were less than (27 .51 ± 12 .44)d and 30 .77% in the control group ,and the differences between the two groups showed the statistical significance (t=3 .128 ,χ2 =5 .446 ,P=0 .000) . The 5-year survival rate in different TNM stages had no statistical difference between the two groups (P>0 .05) .Conclusion For the patients with gastric cancer in the upper and middle portion and entire stomach without spleen or splenogastric ligament metas-tasis ,the modified spleen-preserving lymphadenectomy could make the patients to get the same prognosis as the gastrectomy com-bined with splenectomy ,which reduces the occurrence rate of complications and is worth promoting clinically.