Studies on Necessity of Pancreato-splenectomy for Dissection of Lymph Nodes Along the Splenic Artery and at the Splenic Hylus

Yoshitaka Yamamura, Junichi Sakamoto, Akihito Torii, Katsuhiko Uesaka, Takashi Hirai, Kenzo yasui, Takeshi Morimoto, Tomoyuki Kato, Mitsunori Yasue, Tsuyoshi Kito

Department of Gastroenterological Surgery, Aichi Cancer Center Hospital

Seventy-six patients with pathological metastasis to the lymph nodes at the splenic hylus (No.(10)) were divided into three groups: with splenectomy (S+) 38 cases, with pancreato-splenectomy(PS+) 21 cases, without PS(PS-) 17 cases. The 5-year survival rate of the S(+) group was 10.7%, and those of the PS(+) and PS(-) groups were 17.9% and 17.6%, respectively. There were no significant differences between the three groups. Eighty-two patients with pathological metastasis to the lymph nodes along the splenic artery (No.(10)) were divided into two groups: PS(+) 19 cases, PS(-) 63 cases. The S-year survival rate of the PS(+) group was 10.5%, and that of the PS(-) group 12,8%. There was no significant difference between the two groups. Residual lymph nodes were microscopically detected in the previously dissected pancreas specimen in three of nine cases and the splenic specimen in one of nine cases studied. These lymph nodes were few in number, small in size and all of them were cancer negative. From these results, we concluded that dissection of No.(10) and/or No.(11) without PS might be a clinically satisfactory procedure against advanced gastric carcinoma.

Key words
pancreato-splenectomy, lymph node metastasis of gastric cancer, lymph node at the splenic hylus, lymph node along the splenic artery

Reprint requests
Yoshitaka Yamamura Department of Gastroenterological Surgery, Aichi Cancer Center Hospital
1-1 Kanokoden, Chikusa-ku, Nagoya, 464 JAPAN

Accepted
February 9, 1994

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