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학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
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논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2020.1
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- 1 - 18 (18page)
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Splenic hilar lymph node dissection has been the standard treatment for advanced proximal gastric cancer. Splenectomy is typically performed as part of this procedure. However, splenectomy has some disadvantages, such as increased risk of postoperative complications, especially pancreatic fistula. Moreover, patients who underwent splenectomy are vulnerable to potentially fatal infection caused by encapsulated bacteria. Furthermore, several studies have shown an association of splenectomy with cancer development and increased risk of thromboembolic events. Therefore, splenectomy should be avoided if it does not confer a distinct oncological advantage. Most studies that compared patients who underwent splenectomy and those who did not failed to demonstrate the efficacy of splenectomy. Based on the results of a randomized controlled trial conducted in Japan, prophylactic dissection with splenectomy is no longer recommended in patients with gastric cancer with no invasion of the greater curvature. However, patients with greater curvature invasion or those with remnant gastric cancer still need to undergo splenectomy to facilitate splenic hilar node dissection. Spleen-preserving splenic hilar node dissection is a new procedure that may help delink splenic hilar node dissection and splenectomy. In this review, we examine the evidence pertaining to the efficacy and disadvantages of splenectomy. We discuss the possibility of spleen-preserving surgery for prophylactic splenic hilar node dissection to overcome the disadvantages of splenectomy.
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참고문헌 (73)
참고문헌 신청
Sasada S / 2009 / Frequency of lymph node metastasis to the splenic hilus and effect of splenectomy in proximal gastric cancer / Anticancer Res 29:3347~3351
Ito H / 2013 / Prognostic impact of prophylactic splenectomy for upper-third gastric cancer : a cohort study / Anticancer Res 33:277~282
Kunisaki C / 2007 / Impact of splenectomy in patients with gastric adenocarcinoma of the cardia / J Gastrointest Surg 11:1039~1044
Zhu GL / 2012 / Splenic hilar lymph node metastasis independently predicts poor survival for patients with gastric cancers in the upper and/or the middle third of the stomach / J Surg Oncol 105:786~792
Ishikawa S / 2009 / Pattern of lymph node involvement in proximal gastric cancer / World J Surg 33:1687~1692
Ito H / 2013 / Prognostic impact of prophylactic splenectomy for upper-third gastric cancer : a cohort study / Anticancer Res 33:277~282
Kunisaki C / 2007 / Impact of splenectomy in patients with gastric adenocarcinoma of the cardia / J Gastrointest Surg 11:1039~1044
Zhu GL / 2012 / Splenic hilar lymph node metastasis independently predicts poor survival for patients with gastric cancers in the upper and/or the middle third of the stomach / J Surg Oncol 105:786~792
Ishikawa S / 2009 / Pattern of lymph node involvement in proximal gastric cancer / World J Surg 33:1687~1692
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