J.Jpn. Surg. Soc.. 93(2): 128-132, 1992

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Original article

LYMPH NODE DISSECTION AROUND THE SPLENIC ARTERY FOR GASTRIC CANCER
―A COMPARATIVE STUDY OF PANCREATECTOMY AND PANCREAS-PRESERVING OPERATION-

From 1977 to 1988, four hundred and sixty-five patients received total or proximal gastrectomy for advanced gastric cancer without leaving a tumor mass at National Cancer Center Hospital. Of these, 182 patients received distal pancreatectomy (PS) and 123 received pancreas-preserving operation with removal of the splenic artery (PP).
The 5-year survival rate for the PS group (32.0%) was significantly lower than 61.0% for the PP group. Concerning grades of cancer stage, the 5-year survival rates for the PP group were better than those for the PS group in stages 1, 2 and 3.
Seventy-four of the 465 patients were found to have histologically proven metastatic nodes around the splenic artery.
Their 5-year survival rates were 9.2% for the PS group (n=46) and 32.7% for the PP group (n=13) respectively. Considering the difference in the background factors, these data suggest the effectiveness of the pancreas-preserving operation for advanced gastric cancer even with microscopic lymph node metastasis around the splenic artery.
The pancreas-preserving operation with removal of the splenic artery might be indicated for the patient without definite macroscopically metastatic lymph node around the splenic artery.

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