END RESULTS OF SIMULTANEOUS SPLENECTOMY IN PATIENTS UNDERGOING TOTAL GASTRECTOMY FOR GASTRIC-CARCINOMA

Background. Splenectomy often is performed simultaneously with total g astrectomy for gastric carcinoma to facilitate dissection of splenic h ilar lymph nodes. Splenectomy, however, should be avoided as frequentl y as possible because of its important role in the reticuloendothelial system and because of its sometimes severe complications. We evaluate d the end results of simultaneous splenectomy with total gastrectomy. Methods. The effect of splenectomy on survival was examined by retrosp ective analysis of 245 patients undergoing total gastrectomy for gastr ic carcinoma. Of these, 154 underwent splenectomy, and 91 did not. Pro gnostic factors for patients undergoing total gastrectomy were determi ned. The relationship to postoperative complications also was analyzed . Results. No significant differences overall were found between the 5 -year survival of the patients undergoing total gastrectomy with or wi thout splenectomy. No correlation to any prognostic factor was seen wi th splenectomy. In contrast, splenectomy was independently associated with postoperative complications. Conclusions. In this retrospective s tudy simultaneous splenectomy at total gastrectomy for gastric cancer did not have an effect on the survival rate of patients undergoing tot al gastrectomy, and it sometimes caused severe complications.