A Comparison of Distal Pancreatectomy and the Cancreas-preserving Operation for Advanced Gastric Cancer in Regard to the Quality of Life of the Patients and the Treatment Results.

平, 木下; 圭一, 丸山; 三津留, 笹子; 繁和, 大山

doi:10.5833/jjgs.25.2618

Cited by 4 publications

(2 citation statements)

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“…1 Survival curves of patients with stage 3 tumours who had total gastrectomy with pancreaticosplenectomy or splenectomy alone Fig. 2 Survival curves of patients with stage 4 tumours who had total gastrectomy with pancreaticosplenectomy or splenectomy alone rate is lower in Japan and does not usually exceed 10 per cent in most hospitals 16,17 . In the present study the mortality rates were 5 and 6 per cent after additional pancreaticosplenectomy and splenectomy respectively.…”

Section: Discussionmentioning

confidence: 99%

No survival benefit from combined pancreaticosplenectomy and total gastrectomy for gastric cancer

Kitamura

Nishida

Ichikawa

et al. 1999

Journal of British Surgery

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Section: Discussionmentioning

confidence: 99%

No survival benefit from combined pancreaticosplenectomy and total gastrectomy for gastric cancer

Kitamura

Nishida

Ichikawa

et al. 1999

Journal of British Surgery

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“…The morbidity and mortality rate after total gastrect0my with pancreaticosplenectomy were 56% and 16%, respectively, in a Medical Research Council study from UK [4], which concluded that pancreaticosplenectomy appears to be disadvantageous to gastric cancer patients [5]. Most Japanese series, however, report lower mortality rates, Which did not exceed 10% [6,7]. The difference in reported complications is usually explained by inexperience with the surgical technique, patient obesity, or case-mix, although these factors were not reported in the Dutch series [2].…”

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confidence: 99%

Higher morbidity and mortality after combined total gastrectomy and pancreaticosplenectomy for gastric cancer

Shen

et al. 2002

World j. surg.

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Total gastrectomy with pancreaticosplenectomy for gastric cancer has been proposed for facilitating lymph node dissection or for resection of direct tumor invasion to the pancreas, especially for T4 lesions. Its effectiveness in improving patient survival is still controversial, and higher morbidity and mortality with this procedure have been reported in several series. Such risks to patient survival were not observed in the Japanese series. Based on a prospective gastric cancer database maintained from 1987 to 1999 in our institution, the morbidity and mortality were analyzed in our series of pancreaticosplenectomies. A total of 1,278 patients with gastric cancer received gastrectomy in our surgical unit. Of these, 127 patients underwent curative total gastrectomy with pancreaticosplenectomy in order to facilitate lymph node dissection or removal of direct tumor invasion. Operative time, postoperative hospital stay, postoperative complications, and surgical mortality were analyzed. Compared to another 201 total gastrectomies, longer mean operative time (7.91 +/- 2.16 hours vs. 6.67 +/- 2.01, p <0.001) and postoperative hospital stay (median, 24.5 days vs. 17, p <0.001) for combined organ resection (pancreaticosplenectomy) were shown in this series. The major complication rate, including intraabdominal abscess, anastomotic leak, postoperative bleeding, pancreatitis/fistula, chylous leak, and general complications causing unstable vital signs (26.8% vs. 11.9%, p = 0.001), but not the mortality rate (6.3% vs. 4.8%, p = 0.608), was also shown to be higher in pancreaticosplenectomy patients. The most frequent fatal complication was intraabdominal abscess. However, more than 50% of complications occurred in the first 40 pancreaticosplenectomies (1987-1991); after adequate accumulation of experience, the total complication rate (57.5% vs. 35.6%, p = 0.021), major complication rate (40% vs. 20.7%, p = 0.022), and mortality rate (17.5% vs. 1.1%, p = 0.001) improved significantly in the remaining 87 patients (1991-1999). We therefore conclude that total gastrectomy with pancreaticosplenectomy can be performed by experienced surgeons with acceptable risk of morbidity and mortality.

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Is It Correct Whether Pancreato-Splenectomy Is Essential for Dissection and Removal of Lymph Nodes Along the Splenic Artery?

Yamamura

Kito

Sakamoto

et al. 1993

Recent Advances in Management of Digestive Cancers

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A Comparison of Distal Pancreatectomy and the Cancreas-preserving Operation for Advanced Gastric Cancer in Regard to the Quality of Life of the Patients and the Treatment Results.

Cited by 4 publications

References 1 publication

No survival benefit from combined pancreaticosplenectomy and total gastrectomy for gastric cancer

No survival benefit from combined pancreaticosplenectomy and total gastrectomy for gastric cancer

Higher morbidity and mortality after combined total gastrectomy and pancreaticosplenectomy for gastric cancer

Is It Correct Whether Pancreato-Splenectomy Is Essential for Dissection and Removal of Lymph Nodes Along the Splenic Artery?

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