Gastrectomy with spleen preservation in patients with stomach cancer

Chernousov A.F.; Khorobrykh T.V.; Rogal M.M.

doi:https://doi.org/

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Abstract:

It was analyzed the results of surgical treatment of 118 patients with stomach cancer. Lymphadenectomy and gastrectomy were done in all cases. All patients were divided into two groups. Gastrectomy and splenectomy were performed in the first group, gastrectomy with preservation of spleen was done in the second group. It was revealed that splenectomy is not an independent prognostic factor influencing on prolonged survival of patients with stomach cancer. Preservation of spleen permits to reduce the number of early postoperative complications.

Keywords:

cancer of stomach

gastrectomy

lymphadenectomy

splenectomy

preservation of spleen

Authors:

Chernousov A.F.

Department of faculty surgery №1, Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation, Moscow, Russia

Khorobrykh T.V.

Rogal M.M.

Research Emergency Institute named after N. V. Sklifosovskiy

SPIN RSCI: 4591-3844
Scopus AuthorID: 57022352600
ResearcherID: M-2090-2018
ORCID: 0000-0003-1327-6973

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References:

Аbakumov M.M., Tveritneva L.F., Titova T.I., Il'nitskaya T.I. KHirurgicheskaya taktika pri povrezhdeniyakh selezenki [Surgical tactics ininjuries ofthe spleen]. Vestn khir1989; 143: 10: 134-138.(in Russian)
Аzimov R.KH., Kubyshkin V.А. Rak kardii. Vybor khirurgicheskojtaktiki [The choice of surgicaltactics]. KHirurgiya 2004; 8: 66-71.(in Russian)
Аrutyunyan G.А., Krzhyzhanovskij А.I., Selin S.M., Аrutyunyan V.А., Polikarpov S.А. Neposredstvennye rezul'taty khirurgicheskogo lecheniya raka zheludka [Immediate results of surgical treatment of gastric cancer]. KHirurgiya 2003; 7: 55-58.(in Russian)
Аrutyunyan G.А., Kryzhanovskij А.I., Selin S.M., Аrutyunyan V.А. Rasshirennaya limfadenehktomiya v ob"eme D2 i D3 v khirurgicheskom lechenii raka zheludka [Extendedlymphadenectomyin the amount ofD2 and D3in the surgical treatmentof gastric cancer]. Аnnaly khir 2002; 2: 41-46.(in Russian)
Аfendulov S.А. Torakoabdominal'nye raneniya selezenki [Thoracoabdominalinjuries of spleen]. Klinkhir 1985; 10: 62.(in Russian)
Barta I. Selezenka [Spleen]. Budapesht 1976; 264.(in Russian)
Vashakmadze L.А., Pikin O.V. Mesto palliativnykh operatsij vlechenii rasprostranennogo raka zheludka: sovremennoe sostoyanie problem [Palliative surgeryin the treatment ofadvanced gastric cancer: state of the art]. Ros onkol zhurn 2000; 5: 47-51.(in Russian)
Vinnichenko А.V., Uvarov I.B. Rannij posleoperatsionnyj period posle rasshirennoj limfadenehktomii po povodu raka zheludka [The early postoperative periodafter an extendedlymphadenectomyfor gastric cancer]. Materialy 5-go Vserossijskogo s"ezda onkologov. Kazan'2000.(in Russian)
Davydov M.I., Lagoshnyj А.T., Stilidi I.S., Ter-Ovanesov M.D. Puti uluchsheniya khirurgicheskogo lecheniya raka proksimal'nogootdela zheludka [Improvement of surgical treatment of cancerof the stomach proximalpart]. Ros onkol zhurn 1996; 1: 17-19.(in Russian)
Dzhuraev M.D. Rezul'taty khirurgicheskogo, kombinirovannogo I kompleksnogo lecheniya raka zheludka III stadii po osnovnymfaktoram prognoza [Results of surgical, combined and complex treatmentof stage IIIgastric cancerbymajor predictors]. Ros onkol zhurn 2000; 3: 18-21.(in Russian)
Ershov V.V. CHrezbryushinnaya gastrehktomiya v sovremennoj planovoj i urgentnoj khirurgii [Transabdominalgastrectomyin modernroutineandurgent surgery]: Аvtoref. dis. ... d-ra med. nauk. Nizhnij Novgorod 2001.(in Russian)
Zimin YU.I. Stress: immunologicheskie aspekty [Stress: immunological aspects]. V kn.: Аktual'-nye problemy molekulyarnoj i klinicheskoj immunologii. M1983; 12: 41-62.(in Russian)
Ivanov B.А. K voprosu o povrezhdeniyakh selezenki [Injuriesof the spleen]. Voen.-medzhurn 1983; 10: 60.(in Russian)
Kushh N.L., ZHurilo G.А., Sopov G.А. Otdalennye rezul'taty splenehktomii v detskom vozraste pri zakrytykh povrezhdeniyakh selezenki [Long-term resultsof splenectomyin childrenwithclosed injuries ofthe spleen]. Vestn khir 1986; 137: 12: 65-69.(in Russian)
Laletin V.G., CHikoteev S.P., SHaposhnik M.V. i dr. Rasshirennayalimfadenehktomiya pri operatsiyakh po povodu rasprostranennogoraka zheludka [Extendedlymphadenectomyin surgery forcommonstomach cancer]. Vopr onkol 1994; 40: 7-12: 337-341.(in Russian)
Onopriev V.I. Voprosy gastroehnterologii [Questions ofgastroenterology]. Stavropol': Stavro-pol'skoe kn. izd-vo 1966; 246-262.(in Russian)
Pavlovskij M.P., CHuklin S.А., Orel G.L. Vliyanie splenehktomiina immunologicheskuyu reaktivnost' [Effect ofsplenectomyon the immunological reactivity]. Obzor. KHirurgiya 1986; 6:136-141.(in Russian)
Petrov R.V. Immunologiya [Immunology]. M 1983; 368.(in Russian)
Tyulyandin S.А. KHimioterapiya raka zheludka [Chemotherapy of gastric cancer]. Prakticheskaya onkologiya 2001; 3: 44-51.(in Russian)
Rajkevich N.P. Dvukhfaznye razryvy pecheni i selezenki [Biphasic liver and spleen ruptures]. KHirurgiya 1984; 3: 73-75.(in Russian)
Romanenko A.E. Zakrytye povrezhdeniya zhivota [Closedabdominal injury]. Kiev 1985; 207.(in Russian)
Rusanov А.А. Rak zheludka [Stomach cancer]. L: Meditsina 1979; 232.(in Russian)
Sigal M.Z., Аkhmetzyanov F.SH. Gastrehktomiya i rezektsiya zheludkapo povodu raka [Gastrectomyandgastric resectionfor cancer]. Kazan' 1991; 360.(in Russian)
Skoropad V.YU., Berdov B.А. Аd"yuvantnaya khimioterapiya i khimioluchevaya terapiya operabel'nogo raka zheludka: sovremennoe sostoyanie problem [Adjuvant chemotherapyandchemoradiotherapyfor resectablegastric cancer: state of the art]. Vopr onkol 2004; 50: 4: 524-532.(in Russian)
Skoropad V.YU., Berdov B.А., KHichieva G.А. Rak tela zheludka: sravnitel'nyj analiz rezul'tatov khirurgicheskogo i kombinirovannogo lecheniya [Cancerof the bodyof the stomach: a comparative analysis of surgicaland combined treatment]. Voprosy onkol 2004; 50: 1: 86-90.(in Russian)
Smolyar А.N. KHirurgicheskaya taktika pri povrezhdeniyakh selezenki v svete blizhajshikh i otdalennykh rezul'tatov [Surgical tactics ininjuries ofthe spleenin the light ofthe immediate andlong-term results]: Аvtoref dis. ...kand. med. nauk. M 2001; 187.(in Russian)
Statistika zlokachestvennykh novoobrazovanij v Rossii I stranakh SNG v 2007 g [StatisticsmalignanciesinRussiaand the CISin 2007]. Pod red. akad. RАN i RАMN M.I. Davydova, d-ra biol. nauk E.M. Аksel'. Vestnik RONTS 2009; 20: 3(pril. 1).(in Russian)
Stilidi I.S., Ryabov А.B., Sviridov А.А. Splenosokhrannye operatsii v khirurgii raka zheludka [Spleen-preserving operation in gastric cancer surgery]. Ros onkol zhurn 2007; 4: 17-21.(in Russian)
Tarasov V.А., Vinogradova M.V., Klechikov V.Z., Belyaev A.M., Аndreasyan А.G. KHirurgicheskoe lechenie rasprostranennykh form rakazheludka [Surgical treatment ofcommon forms of cancerof the stomach]. Praktich onkol 2001; 3: 7: 52-58.(in Russian)
Uchitel' I.YA. Makrofagi v immunitete [Macrophagesin immunity]. M 1978; 234.(in Russian)
CHernousov А.F., Polikarpov S.А., CHernousov F.А. KHirurgiya rakazheludka [Gastric cancer surgery]. M: IzdАT 2004; 560.(in Russian)
CHissov V.I., Аverbakh А.M. Rasshirennaya limfadenehktomiya prirake zheludka [Extendedlymphadenectomy forgastric cancer]. KHirurgiya 1998; 1: 52-56.(in Russian)
SHHepotin I.B., EHvans S.R.T. Rak zheludka: prakticheskoe rukovodstvo po profilaktike, diagnostike i lecheniyu [Gastric cancer: a practical guide for the prevention, diagnosis and treatment]. Kiev: Knigaplyus 2000; 229.(in Russian)
Adachi Y., Kamakura T., Mori M. et al. Role of lymph node dissection and splenectomy in node positive gastric carcinoma. Syrgery 1994; 116: 837-841.
Adachi Y., Kitano S., Sugimachi S. Surgery for gastric cancer: 10-year experience worldwide. Gastric Cancer 2001; 4: 4: 166-174.
Brennan M.F. Current status of surgery for gastric cancer: a review. Gastric Cancer 2005; 8: 2: 64-70.
Bonenkamp J., Songun I., Welvaart K., van de Velde C., Hermans J., Sasako M. et al. Randomised comparison of morbidity after D1 and D2 dissection for gastric cancer in 996 Dutch patients. Lancet 1995; 345: 745-748.
Chaikof E.L., McCabe Ch.J. Fatal overwhelming postsplenectomy infection. Amer J Surg 1985; 149: 4: 534-539.
Csendes A., Burdiles P., Rojas J. et al. A prospective randomized study comparing D2 total gastrectomy versus D2 total gastrectomy plus splenectomy in 187 patients with gastric carcinoma. Surgery 2002; 131: 401-407.
Cuschieri A., Joypaul V., Fayers P., Cook P., Fielding J., Craven J. et al. Postoperative morbidity and mortality after D1 and D2 resections for gastric cancer: preliminary results of the MRC randomised controlled surgical trial. The Surgical Cooperative Group. Lancet 1996; 347: 995-999.
Degiuli M., Sasako M., Calgaro M., Garino M., Rebecchi F., Mineccia M. et al. Morbidity and mortality after D1 and D2 gastrectomy for cancer: interim analysis of the Italian Gastric Cancer Study Group (IGCSG) randomised surgical trial. Eur J Surg Oncol (EJSO) 2004; 30: 303-308.
De Manzoni G., Verlato G., Guglielmi A. et al. Prognostic significance of lymph node dissection in gastric cancer. Br J Surg 1996; 83: 11: 1604-1607.
Diaz Plasencia J., Tantalean E., Guzman C. et al. Gastric cancer: diagnosis and role of lymphadenectomy in surgical treatment. Rev Gastroenterol Peru 1997; 17: 1: 44-55.
Durig M., Heberer M., Wadstrom J. et al. Die Replantation autologen Milzgevebes in das Omentum majus: eine Alternative zur Splenectomie? Helv chir Acta 1982; 49: 6: 795-798.
Fry D.E., Garisson R.N., Williams H.S. Patterns of morbidity and mortality in splenic trauma. Amer Surg 1980; 46: 28-32.
Furukawa H., Hiratsuka M., Ishikawa O., Ikeda M., Imamura H., Masutani S. et al. Total gastrectomy with dissection of lymph nodes along the splenic artery: a pancreas-preserving method. Ann Surg Oncol 2000; 7: 669-673.
Hickman A., Wilson S.K., Stein M., Lewis J. Portal and superior mesenteric venous thrombosis following splenectomy. J Tenn Med Assoc 1991; 84: 7: 329-330.
Japanese Gastric Cancer Association. Japanese gastric cancer treatment guidelines 2010 (ver. 3). Gastric Cancer 2011; 14: 113-123.
Jemal A., Siegel R., Ward E. et al. Cancer statistics, 2008. CA Cancer J Clin 2008; 58: 71-96.
Kodama Y., Sugimashi K., Soejima K. et al. Evaluation of extensive lymph node dissection for carcinoma of the stomach. World J Surg 1981; 5: 2: 241-248.
Lee J., Demissie K., Lu S.E. et al. Cancer incidence among Korean-American immigrants in the United States and native Koreans in South Korea. Cancer Control 2007; 14: 78-85.
Mine M., Majima S., Harada M., Etani S. End results of gastrectomy for gastric cancer: Effect of extensive lymph node dissection. Surgery 1970; 68: 753-758.
Nakajima T. Gastric cancer treatment guidelines in Japan. Gastric cancer 2002; 5: 1-5.
Okajima K., Isozaki H. Splenectomy for treatment of gastric cancer: Japanese experience. World J Surg 1995; 19: 537-540.
Okinaga K., Iinuma H., Kitamura Y., Yokohata T., Inaba T., Fukushima R. Effect of immunotherapy and spleen preservation on immunological function in patients with gastric cancer. J Exp Clin Cancer Res 2006; 25: 341.
Pate J.W., Peters T.G., Andrews C.R. Postsplenectomy Complications. Amer Surg 1985; 51: 8: 437-441.
Sano T., Yamamoto S., Sasako M. Randomized controlled trial to evaluate splenectomy in total gastrectomy for proximal gastric carcinoma: Japan Clinical Oncology Group study JCOG 0110-MF. Jpn J Clin Oncol 2002; 32: 363-364.
Savtaj S. Brar, Rajini Seevaratnam, Roberta Cardoso, Calvin Law, Lucy Helyer, Natalie Coburn. A systematic review of spleen and pancreas preservation in extended lymphadenectomy for gastric cancer. Gastric cancer 2012; 15: 1: 89-99.
Siewert J.R., Bottcher K., Roder J.D. et al. Prognostic relevance of systematic lymph node dissection in gastric carcinoma. German Gastric Carcinoma Study Group. Br J Sur 1993; 80: 8: 1015-1018.
World Health Organization Cancer. World Health Organization Fact Sheet No. 297. 2 2009. Available at accessed 2009.
Yu W., Choi G., Chung H. Randomized clinical trial of splenectomy versus splenic preservation in patients with proximal gastric cancer. Br J Surg 2006; 93: 559-563.