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A prospective randomized study comparing D2 total gastrectomy versus D2 total gastrectomy plus splenectomy in 187 patients with gastric carcinoma.

Attila Csendes·Patricio Burdiles·Jorge Rojas·Italo Braghetto·Juan Carlos Diaz·Fernando Maluenda
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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.

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AdultAgedAged, 80 and overCarcinomaFollow-Up StudiesGastrectomyHumansIncidenceInfantInfectionsLength of StayLymphatic MetastasisLymphomaMaleMiddle AgedPostoperative ComplicationsProspective StudiesSplenectomyStomach NeoplasmsSurvival AnalysisClinical TrialComparative StudyJournal ArticleRandomized Controlled Trial

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Attila Csendes, Patricio Burdiles, Jorge Rojas, Italo Braghetto, Juan Carlos Diaz, Fernando Maluenda. 2002. A prospective randomized study comparing D2 total gastrectomy versus D2 total gastrectomy plus splenectomy in 187 patients with gastric carcinoma.. https://doi.org/10.1067/msy.2002.121891

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