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

    loading  Checking for direct PDF access through Ovid


BackgroundPreservation or removal of the spleen during total gastrectomy for proximal gastric cancer is a matter of debate.MethodsA 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.ResultsGastrectomy 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.ConclusionThese 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.

    loading  Loading Related Articles