| Objective: The influence of splenectomy on survival after gastrectomy for gastric cancer remains controversial. To clarify this issue,the present study employed meta analytic principles in a quantitative review of literature.Methods: All the randomized and no randomized clinical trials about gastrectomy associated splenectomy for gastric cancer or not published between January 1 1995 and December 31 2007 were collected.Quality assessment was done on each trial and relevant data were extracted from qualified trials. Meta-analysis was performed with the Use of RevMan 4.2(Cochrane)for statistic analysis.Results: 329 trials were yielded at the initial search.2 randomized trials and 17 no randomized trials,recruited 394 cases in randomized trials and 6761 cases in no randomized trials of gastric cancer in total were included after quality assessment . Results of Meta-analysis showed that gastrectomy associated splenectomy could not effectively improve patients'long-term survival compared with gastrectomy alone[Randomized clinical trials RR 1.0,95%CI(0.81～1.24);No randomized clinical trials OR 0.54,95%CI(0.42～0.69)]; Gastrectomy associated splenectomy produced higher rates of postoperative complication than Gastrectomy only[Randomized clinical trials RR 1.70,95%CI(1.30～2.23)and No randomized clinical trials OR 2.04,95%CI(1.45～2.88)] There had no significant difference in the mortality of two ways.[Randomized clinical trials RR 1.58 , 95 % CI(0.45～5.50)and No randomized clinical trials OR 1.18,95%CI(0.94～1.49)].Conlusions: Comparison between splenectomy and spleenpreservation in radical treatment of gastric cancer, the former not only fail to improve long-term survival in patients with gastric cancer patients has also increased the overall incidence of complications but the two groups no significant difference in mortality.
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