The selection of surgical treatment for gastric cancer patients with cirrhosis and hypersplenism

Hepatogastroenterology. 2014 Jan-Feb;61(129):232-5.

Abstract

Background/aims: This study is to find the changes of hypersplenism, the leukocyte, platelets count, blood loss and operative time, hospitalization days in gastric cancer patients with cirrhosis and hypersplenism after splenectomy or splenic artery ligation.

Methodology: 32 gastric cancer patients with cirrhosis and hypersplenism were divided into two groups performed radical gastrectomy combined with splenectomy (Group A, n = 17) or splenic artery ligation (Group B, n = 15), 16 gastric cancer patients performed radical gastrectomy were selected as control group (Group C). Then, statistical analyzed.

Results: There were no significant differences of the leukocyteand platelets between Group A and B (p > 0.05), but significant compared with Group C (p < 0.01). After 6 chemotherapy, the differences of the leukocyteand platelets were obvious between Group A and C (p < 0.05), but not between Group B and C (p > 0.05). There were significant differences on the grading of hyperhepatia between Group A and B. Except the operative time of Group B and C (p > 0.05), there were significant differences on the blood loss, the operative time and hospitalization days among three groups (p < 0.05).

Conclusions: The splenic artery ligation method was much more rational than splenectomy and it was preferred for the gastric cancer patients with cirrhosis and hypersplenism.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Blood Loss, Surgical / statistics & numerical data
  • Combined Modality Therapy
  • Female
  • Fluorouracil / therapeutic use
  • Gastrectomy
  • Humans
  • Hypersplenism / complications*
  • Hypersplenism / surgery*
  • Length of Stay / statistics & numerical data
  • Leucovorin / therapeutic use
  • Leukocyte Count
  • Liver Cirrhosis / complications*
  • Male
  • Middle Aged
  • Operative Time
  • Organoplatinum Compounds / therapeutic use
  • Platelet Count
  • Splenectomy
  • Stomach Neoplasms / complications*
  • Stomach Neoplasms / drug therapy
  • Stomach Neoplasms / surgery*

Substances

  • Organoplatinum Compounds
  • Leucovorin
  • Fluorouracil

Supplementary concepts

  • Folfox protocol