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Review of Splenectomy, Pancreas-preserving Splenectomy, Pancreatosplenectomy for Combined Radical Total Gastrectomy

Other Title
비장절제술을 동반하는 위암의 수술방법들에 대한 임상적 고찰
Authors
민, 근식; 차, 진우; 김, 명욱; 조, 용관; 한, 상욱; 김, 지훈
Citation
Taehan Oekwa Hakhoe, 63(5):397-402, 2002
Journal Title
Taehan Oekwa Hakhoe; 대한외과학회지
ISSN
1226-0053
Abstract
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

the

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

node

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,

location

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

a

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

who

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.
Keywords
Gastric cancerTotal gastrectomyPancreas-preserving splenectomy
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Journal Papers > School of Medicine / Graduate School of Medicine > Surgery
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