Safety and Feasibility of Laparoscopic Spleen-Preserving Splenic Hilar Lymphadenectomy During Total Gastrectomy for Advanced Proximal Gastric Cancer: A Randomized Clinical Trial

2020 ◽  
Author(s):  
Jian-Xian Lin ◽  
Ping Li ◽  
Zu-Kai Wang ◽  
Jun-Peng Lin ◽  
Jia-Bin Wang ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Total Gastrectomy ◽  
Proximal Gastric Cancer ◽  
Spleen Preserving ◽  
Splenic Hilar Lymphadenectomy

scholarly journals The Significance of Splenectomy for Advanced Proximal Gastric Cancer

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Atsushi Nashimoto ◽  
Hiroshi Yabusaki ◽  
Atsushi Matsuki
Keyword(s):  
Gastric Cancer ◽  
Total Gastrectomy ◽  
Locally Advanced ◽  
Survival Rates ◽  
Proximal Gastric Cancer ◽  
Term Survival ◽  
Spleen Preserving ◽  
Splenic Hilus ◽  
Better Than

Objectives. The significance of splenectomy in advanced proximal gastric cancer is examined retrospectively.Methods.From 1994 to 2004, 505 patients with advanced proximal gastric cancer underwent curative total gastrectomy with preserving spleen (T) for 264 patients and total gastrectomy with splenectomy (ST) for 241 patients.Results. Patients who underwent splenectomy showed more advanced lesions. The metastatic rate of lymph node (LN) in the splenic hilus (No. 10) in ST was 18.3%. As for the incidence of surgical complications, there was not statistically difference except for pancreatic fistula. The index of estimated benefit of (No. 10) LN was 4.2, which was similar to that of (No. 9), (No. 11p), (No. 11d), and (No. 16) LNs. 5-year survival rate of (No. 10) positive group was 22.2%. 5-year survival rates of pSE and pN2 in T group were better than that of pSE and pN2 in ST, respectively. The superiority of ST was not confirmed even in Stage II, IIIA, and IIIB.Conclusion. Splenectomy was not effective for patients with (No. 10) metastasis in long-term survival. Spleen-preserving total gastrectomy will be feasible and be enough to accomplish radical surgery for locally advanced proximal gastric cancer.

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