Impact of splenectomy on circulating immunoglobulin levels and the development of postoperative infection following total gastrectomy for gastric cancer

Abstract

Splenectomy increases the postoperative morbidity of total gastrectomy for carcinoma of the stomach. The reasons for this increased risk of postoperative infection are unknown. The aim of this study was to evaluate the impact of splenectomy on circulating immunoglobulin levels and to determine whether splenectomy was an independent risk factor for the development of postoperative infection in 154 patients undergoing total gastrectomy for carcinoma of the stomach. Splenectomy reduced circulating immunoglobulin M levels in the early postoperative period following total gastrectomy. However, it was not identified as an independent risk factor for the development of postoperative infection by multivariate analysis.

Immunoglobulin abnormalities and effects of enzyme replacement therapy in children with Gaucher disease

“…Splenectomy has been shown to decrease mostly IgM levels while IgA and IgG levels remain unchanged 9. We also observed that in two of our patients who had splenectomy, IgA levels remained still high while IgG levels tend to decrease but they were still higher than normal.…”

Randomized clinical trial of splenectomy versus splenic preservation in patients with proximal gastric cancer

“…Postoperative mortality rates of 4·4 per cent19 and 6 per cent20 after total gastrectomy with splenectomy have been reported. Several reports have described a higher postoperative morbidity rate with splenectomy than without7, 11, especially infectious complications7 such as intra‐abdominal abscess21, and splenectomy has been independently associated with postoperative complications by logistic regression analysis5, 22.…”

Effect of Simultaneous Splenectomy on the Survival of Patients Undergoing Curative Gastrectomy for Proximal Gastric Carcinoma

“…The only effective treatment for gastric carcinoma is surgical resection, and radical procedures are often performed not only for gastric carcinoma but also for other malignant tumors. [7][8][9][10][11] In fact, some investigators believe that concomitant splenectomy has no effect on prognosis. Splenectomy is the most commonly performed simultaneous operation with radical gastrectomy, and its purpose is to remove direct splenic invasion and dissect metastatic lymph nodes located in the splenic hilus or around the splenic artery.…”