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Title   위암 환자의 위전절제술시 비장절에가 예후에 미치는 영향에 관한 연구 ( Effects of Combined Splenectomy with Total Gastrectomy on the Prognsis in Gastric Cancer )
Publicationinfo   1997 Jan; 029(04): 632-640.
Key_word   Gastric cancer, Splenectomy, Prognosis
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Abstract   Purpose: This study was carried out to evaluate the impact of combined splenectomy with total gastrectomy on survival and postoperative morbidity in advanced gastric cancer. Patients and Methods: We performed a retrospective analysis of 193 patients who underwent curative resection among 289 patients with total gastrectomy during the period of Sep. 1983 through Dec. 1995 at the Department of Surgery, Korea University Hospital. Results: Out of 11 clinicopathologic factors, 5 were associated with splenectomy through univariate analysis. The incidence of splenectomy increased when the patients with advanced gastric cancer had Borrmann type III, Gross T3 & T4 stage, greater than 4 cm of tumor size, Serosal invasion, or UICC stage IIIb, IV(p <0.05). Postoperative complication occurred more commonly in splenectomy group than in non-splenectomy group (20.2% vs 16.9%). The 5-year survival rate of Stage II was lower in splenectomy group than in non-splenectomy group(63.5% vs 83.5%) but that of Stage III was higher in splenectomy group than in non-splenectorny group(22.8% vs 17.3%), there was no significant difference between the survival rates across different stages. Conclusion: We could not find any beneficial effect of splenectomy in gastric cancer patients who underwent curative total gastrectomy in this retrospective analysis. There was no clinical evidence to support splenectomy as a general policy in patients with total gastrectomy. We conclude that the randomized prospective clinical trials using more precise criteria for the indication of splenectomy are needed in order to assess the beneficial effect of splenectomy.
저 자   목영재(Young Jae Mok),김승주(Seung Joo Kim),손길수(Kil Soo Son),조민영(Min Young Cho),김영철(Young Chul Kim),김세민(Se Min Kim)