Morbidity, Mortality and Survival after Stomach Resection with or without Splenectomy – The Single Centre Observations
Journal Title: Polish Journal of Surgery - Year 2013, Vol 85, Issue 8
Abstract
Over the last decade, gastric cancer treatment has changed from extensive multiorgan resections towards less invasive approaches with limited resections and a more selective lymphadenectomy. Despite all available trials, the conclusions on the extent of necessary resections still remain debatable. The aim of the study was to assess the short term outcomes (morbidity and mortality) of a total gastrectomy depending on the simultaneous splenectomy status. Material and methods. We performed a retrospective analysis of the records of all patients treated with a curative intent using a total gastrectomy for gastric cancer between 1997 and 2003. 49 patients fulfilled the inclusion criteria. Patients were divided into two groups: S(+) gastrectomy with splenectomy group (29 patients) and S(-) total gastrectomy with spleen preservation (20 patients). Results. Survival analysis at one year showed that there was no difference in survival between the two groups (p=0.84). There were six recurrences, one in the group S(+) and five in group S(-) (p>0.05). Dissemination was observed in three patients in group S(-) (p>0.05). Other complications including infectious complications, exenteration, subileus, cardiovascular insufficiency, multiorgan failure were more frequent in the S(+) group (31% v 15%) although the difference was not significant (p=0.17). Conclusions. Splenectomy during gastrectomy for cancer has no statistically significant impact on short-term morbidity and mortality. Even though it does not show benefit in terms of 5-year overall survival rates it might be performed when needed in more advanced cases in properly selected patients (e.g. upper gastric T3/4 gastric cancer).
Authors and Affiliations
Zoran Stojcev, Maciej Bobowicz, Michał Jarząb, Tomasz Pawłowska-Stojcev
Keywords
Related Articles
- EP ID EP74333
- DOI 10.2478/pjs.2013.85.8.433
- Views 97
- Downloads 0
Splenic abscess with bleeding in a female patient following coronary artery bypass grafting and cholecystectomy – a case report and literature review
Splenic abscess is a potential complication of many disease entities which involve infections. Diagnostics are based on imaging studies. Treatment involves splenectomy and antibiotic therapy. In the case the abscess is l...
Erythrophobia - Problems of Diagnostics and Treatment
Retroperitoneal abscess with retained gall-stones as a late complication of laparoscopic cholecystectomy
Laparoscopic cholecystectomy is the golden standard, considering treatment of cholelithiasis. During the laparoscopic procedure one may often observe damage to the gall-bladder wall, as well as presence of gall-stones in...
Laparoscopic cholecystectomy in a patient with total situs inversus – case report
For many years, laparoscopic cholecystectomy remains the method of choice for both the treatment of symptomatic cholelithiasis, and chronic and acute cholecystitis (1). The experience of the surgeon grows with each lapar...
Zachorowalność, chorobowość i 5-letnie przeżycia chorych na raka jelita grubego w Województwie Kujawsko–Pomorskim w latach 2005–2011 na podstawie danych Narodowego Funduszu Zdrowia
Wstęp: Wskaźniki zachorowalności, chorobowości i 5-letnich przeżyć obrazują sytuację epidemiologiczną raka jelita grubego oraz oceniają efektywność podejmowanych działań leczniczych. W Polsce płatnikiem świadczeń jest Na...