title: Morbidity, mortality and survival after stomach resection with or without splenectomy--the single centre observations.
abstract: Over the last decade, gastric cancer treatment has changed from extensive multiorgan resections towards less invasive approaches with limited resections and a more selective lymphadenectomy. Despite all available trials, the conclusions on the extent of necessary resections still remain debatable. The aim of the study was to assess the short term outcomes (morbidity and mortality) of a total gastrectomy depending on the simultaneous splenectomy status.
  
  
  METHODS
  We performed a retrospective analysis of the records of all patients treated with a curative intent using a total gastrectomy for gastric cancer between 1997 and 2003. 49 patients fulfilled the inclusion criteria. Patients were divided into two groups: S(+) gastrectomy with splenectomy group (29 patients) and S(-) total gastrectomy with spleen preservation (20 patients).
  
  
  RESULTS
  Survival analysis at one year showed that there was no difference in survival between the two groups (p=0.84). There were six recurrences, one in the group S(+) and five in group S(-) (p>0.05). Dissemination was observed in three patients in group S(-) (p>0.05). Other complications including infectious complications, exenteration, subileus, cardiovascular insufficiency, multiorgan failure were more frequent in the S(+) group (31% v 15%) although the difference was not significant (p=0.17).
  
  
  CONCLUSIONS
  Splenectomy during gastrectomy for cancer has no statistically significant impact on short-term morbidity and mortality. Even though it does not show benefit in terms of 5-year overall survival rates it might be performed when needed in more advanced cases in properly selected patients (e.g. upper gastric T3/4 gastric cancer).
authors.forename: Zoran
authors.initials: Z
authors.lastname: Stojcev
authors.forename: Maciej
authors.initials: M
authors.lastname: Bobowicz
authors.forename: Michał
authors.initials: M
authors.lastname: Jarząb
authors.forename: Tomasz
authors.initials: T
authors.lastname: Pawłowska-Stojcev
authors.forename: Tomasz
authors.initials: T
authors.lastname: Banasiewicz
mesh_terms: D005260:Female; D005743:Gastrectomy / Q000009:adverse effects / Q000401:mortality*; D006801:Humans; D007902:Length of Stay; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D009366:Neoplasm Seeding; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D013156:Splenectomy / Q000009:adverse effects / Q000401:mortality*; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D016019:Survival Analysis; D015996:Survival Rate