Retrospective Analysis Of Resection Of Advanced Gastric Carcinoma Combined With Splenectomy Distal Pancreatectomy And Splenic Artery Resection

ObjectiveTo further investigate resection possibility of advanced gastric carcinoma, combined with splenectomy,distal pancreatectomy and splenic artery resection,with related foreign and domestic literature.To investigate the surgical effect of advanced carcinoma,to further confirm the choice of surgical methods,and indication for resection of advanced gastric carcinoma combined with splenectomy,distal pancreatectomy and splenic artery resection.MethodsWe have a retrospective analysis the 121 cases of advanced gastric carcinoma combined with splenectomy,distal istal pancreatectomy and splenic artery resection, and of advanced gastric carcinoma not combined with other organ resection in the gastric carcinoma data bank of China Medical University,oncological surgery department before 2003.They were divided into three groups,A group(pancreastectomy group),B group(pancreas-preserving group),C group(palliative group).We analysed andcomparedthe1,3,5yearssurvial rate,mortality,complication morbility with related foreign and domestric literature.We analysed the surgical effect of advanced gastric carcinoma.We used Kaplan-Meier method survival analysis and Fisher statistical probability test to compare.ResultsThree groups complication morbility were 16.07%in group A,0 in group B,2.7% in group C respectively.There were significant differences among the three groups, P＜0.05.The three groups complication morbility were 19.64%in group A,21.43%in group B,and 2.7%in group C.There were significant differences among the three groups,P＜0.05.The morbility of intestinal obstruction and fistula was higher among the three groups.The 1,3,5 years survial rate were 61.7%,27.7%,13.0%in group A, 67.9%,25.0%,3.60%in group B and 30.6%,13.9%,5.60%in group C respectively. There was no significant difference between group A and group B,p＞0.05.The 3 years survival rate was not significant difference between group A and group B p＞0.05.There was significant difference in 3 years survival rate between group A,B and group C. There was no significant differences in survival rate between A,B and C p＞0.05.There was significant difference in survival rate between group A,B and group C,p＜0.05.Conclusion1,The patients survial rate will be prolonged forⅢ,Ⅳstage gastric carcinoma patients,with invasion into spleen,body and tail of pancreas.If their operation is combined with splenectomy and distal pancreatectomy.2,It is unnecessary to resect left distal pancreatectomy to remove No10,No11 lymph node.Resection of spleen and splenic artery is enough.