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Gastric Cancer
Published in: Gastric Cancer 1/2012

01-09-2012 | Review article

A systematic review of spleen and pancreas preservation in extended lymphadenectomy for gastric cancer

Authors: Savtaj S. Brar, Rajini Seevaratnam, Roberta Cardoso, Calvin Law, Lucy Helyer, Natalie Coburn

Published in: Gastric Cancer | Special Issue 1/2012

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Abstract

Background

The overall prognosis and survival of patients with advanced gastric cancer are generally poor. Extended lymphadenectomy is recommended for patients with advanced gastric cancer; however, splenectomy and distal pancreatectomy performed with an extended lymph node dissection may be associated with increased morbidity and mortality.

Method

Electronic literature searches were conducted using Medline, Embase, and the Cochrane Central Register of Controlled Trials from 1 January 1998 to 31 December 2009. Studies on gastric carcinoma investigating extended lymphadenectomy with splenectomy and/or pancreaticosplenectomy that reported data on surgical outcomes or survival were selected.

Results

Forty studies were included in this review. Decreased complication rates were demonstrated with spleen preservation in two prospective studies and three retrospective studies, and with pancreas preservation in five retrospective studies. No randomized controlled trial showed survival benefit or detriment for preservation of spleen or pancreas in extended lymphadenectomy. Improved survival was demonstrated with spleen preservation in two prospective and eight retrospective studies, and with pancreas preservation in one prospective and four retrospective studies.

Conclusions

Preservation of the spleen and pancreas during extended lymphadenectomy for gastric cancer decreases complications with no clear evidence of improvement or detriment to overall survival.
Appendix
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Metadata
Title
A systematic review of spleen and pancreas preservation in extended lymphadenectomy for gastric cancer
Authors
Savtaj S. Brar
Rajini Seevaratnam
Roberta Cardoso
Calvin Law
Lucy Helyer
Natalie Coburn
Publication date
01-09-2012
Publisher
Springer Japan
Published in
Gastric Cancer / Issue Special Issue 1/2012
Print ISSN: 1436-3291
Electronic ISSN: 1436-3305
DOI
https://doi.org/10.1007/s10120-011-0087-4

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