Review of Splenectomy, Pancreas-preserving Splenectomy, Pancreatosplenectomy for Combined Radical Total Gastrectomy
비장절제술을 동반하는 위암의 수술방법들에 대한 임상적 고찰
민, 근식; 차, 진우; 김, 명욱; 조, 용관; 한, 상욱; 김, 지훈
Taehan Oekwa Hakhoe, 63(5):397-402, 2002
Taehan Oekwa Hakhoe; 대한외과학회지
Purpose: Splenectomy, pancreas-preserving splenectomy, pancreato-splenectomy are common combined operations of a total gastrectomy for gastric cancer. We attempted to determine the efficacy of these procedures after comparing and analyzing
complication rate and the five-year survival rate from the gastric cancer patients.
Methods: 121 advanced gastric cancer patients, except T4 patients, underwent radical total gastrectomy accompanied with splenectomy. and analyzed the clinical findings eg. age, sex, location of tumor, histological differentiation, lymph
metastasis, number of dissected LN, complication and the 5-year survival rate.
Results: 44 out of 121 patients underwent a pancreato-splencetomy, 53 patients underwent a pancreas-preserving splenectomy, and 24 patients underwent a simple splenectomy. There were no statistical difference in the patient’s age, sex,
of tumor, histological differentiation, lymph node metastasis, the number of dissected LN and the 5 year-survival rate in stage Ⅱ, Ⅳ with each operation. However, a pancreas-preserving splenectomy showed a better 5-year survival rate (53.7%) than
simple splenectomy (25.0%) and pancreato-splenectomy (32.1%) in stage Ⅲ. The complication rate was 25% in a simple splenectomy, 17% in a pancreas-preserving splenectomy, 30% in a pancreato-splenectomy. Diabetes mellitus occurred in 3 patients
underwent a pancreato-splenectomy, in 1 patient with an iatrogenic splenic vein excision during a pancreas-preserving splenectomy.
Conclusion: A pancreas-preserving splenectomy is the best choice in stage IIIa total gastrectomy patients with the lowest complication rate.
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