Our Summary

This research paper is about a study that looked into the effects of removing the spleen (splenectomy) in patients with stomach cancer. They examined past studies from 1997 to 2018, involving 4457 patients, to see if there were any benefits or downsides to the surgery. They discovered that people who had their spleen removed had a higher chance of experiencing complications after surgery, such as leaks in the area where the stomach was sewn back together, an abscess in the abdomen, or an abnormal connection between the pancreas and the abdomen (pancreatic fistula). These patients also tended to live less long (about 5 years less), and their cancer was more likely to come back, especially in non-randomized controlled trials. However, this was not the case in randomized controlled trials. In conclusion, the research suggests that removing the spleen in stomach cancer patients may lead to more complications after surgery and does not necessarily improve the long-term survival chances.

FAQs

  1. What were the major findings of the study about the effects of removing the spleen in stomach cancer patients?
  2. What are some potential complications after the surgery for stomach cancer patients who had their spleen removed?
  3. Does the removal of the spleen in stomach cancer patients improve their long-term survival chances?

Doctor’s Tip

A helpful tip a doctor might tell a patient about gastrectomy is to carefully weigh the potential benefits and risks of the surgery before making a decision. It is important to discuss all possible outcomes with your healthcare team and ask any questions you may have. Additionally, following a healthy lifestyle, including a balanced diet and regular exercise, can help support recovery and overall well-being after gastrectomy.

Suitable For

Patients who are typically recommended for a gastrectomy include those with early-stage stomach cancer, severe peptic ulcers that cannot be treated with medication, or benign tumors in the stomach that are causing symptoms. Additionally, individuals with a family history of stomach cancer or certain genetic conditions that increase the risk of developing the disease may also be recommended for a gastrectomy as a preventive measure. Ultimately, the decision to undergo a gastrectomy is based on the specific circumstances of each patient and should be carefully discussed with a healthcare provider.

Timeline

Before gastrectomy:

  • Patient is diagnosed with stomach cancer through imaging tests, biopsies, and other diagnostic procedures.
  • Patient undergoes preoperative assessments and consultations with their healthcare team to determine if gastrectomy is the best treatment option.
  • Patient may undergo chemotherapy and/or radiation therapy to shrink the tumor before surgery.
  • Patient receives instructions on how to prepare for surgery, including fasting and stopping certain medications.
  • Patient undergoes gastrectomy surgery to remove part or all of the stomach, depending on the extent of the cancer.

After gastrectomy:

  • Patient is closely monitored in the hospital for complications such as infection, bleeding, and leakage from the surgical site.
  • Patient may experience side effects such as pain, nausea, and changes in digestion and appetite.
  • Patient receives nutrition support to help with digestion and maintain adequate nutrient intake.
  • Patient undergoes follow-up appointments with their healthcare team to monitor their recovery and address any concerns.
  • Patient may need to make dietary and lifestyle changes to adjust to life without a stomach, such as eating smaller, more frequent meals and taking vitamin supplements.
  • Patient may undergo adjuvant therapy such as chemotherapy or targeted therapy to reduce the risk of cancer recurrence.
  • Patient continues to be monitored for long-term side effects and complications related to gastrectomy.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with gastrectomy, particularly in relation to the removal of the spleen?
  2. How will the removal of my spleen affect my long-term survival chances?
  3. Are there alternative treatment options available that do not involve removing the spleen?
  4. What is the success rate of gastrectomy in treating stomach cancer, both with and without splenectomy?
  5. Will I need any additional treatments or follow-up care after gastrectomy, especially if my spleen is removed?
  6. How will the removal of my spleen impact my quality of life post-surgery?
  7. Are there any specific factors or characteristics that may make me a better or worse candidate for splenectomy during gastrectomy?
  8. What is the recovery process like after gastrectomy, and how long can I expect to be in the hospital and/or out of work?
  9. Are there any ongoing clinical trials or research studies investigating the benefits or risks of splenectomy in gastrectomy patients that I should be aware of?
  10. How will the presence or absence of the spleen impact my body’s ability to fight off infections and other illnesses in the future?

Reference

Authors: Li Z, Lian B, Chen J, Song D, Zhao Q. Journal: Int J Surg. 2019 Aug;68:104-113. doi: 10.1016/j.ijsu.2019.06.018. Epub 2019 Jul 2. PMID: 31271929