Abstract:
BACKGROUND:Classic surgical treatment of upper third gastric carcinoma is based on an extended total gastrectomy, including splenectomy. The purpose of this study was to perform a prospective randomized clinical trial comparing the early and late results of total gastrectomy (TG) versus total gastrectomy plus splenectomy (TGS). METHODS:One hundred eighty-seven patients with gastric carcinoma were included. In all patients a D2 total gastrectomy was performed. During surgery they were randomized to 1 of 2 operative options. They were monitored to their death or to 5 years later if they were alive. RESULTS:Operative mortality was similar after both operations (3% after TG and 4% after TGS). Septic complications after surgery were higher after TGS compared with TG (P <.04). Five-year survival rates were not statistically different between groups or in subset analysis according to stage of disease. CONCLUSIONS:On the basis of the results of the present prospective randomized trial, splenectomy is not necessary in early stages of disease. A low operative mortality rate (less than 3%) must be achieved to obtain good long-term results.
journal_name
Surgeryjournal_title
Surgeryauthors
Csendes A,Burdiles P,Rojas J,Braghetto I,Diaz JC,Maluenda Fdoi
10.1067/msy.2002.121891subject
Has Abstractpub_date
2002-04-01 00:00:00pages
401-7issue
4eissn
0039-6060issn
1532-7361pii
S0039606002371654journal_volume
131pub_type
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