Our Summary

This research paper is a review of several previous studies comparing two different methods of surgery for gastric (stomach) cancer. One method involves removing the spleen (known as splenectomy or SP), while the other method preserves the spleen (non-splenectomy or NSP).

The researchers examined data from over 5000 patients who had undergone radical surgery for stomach cancer. They found that surgeries that involved removing the spleen were associated with a higher rate of complications after the operation, including issues with the lungs, abscesses in the abdomen, and problems with the pancreas.

However, there was no significant difference in terms of how many patients died, wound infections, leakage at the surgical site, or five-year survival rates after the surgery.

In conclusion, the researchers suggest that removing the spleen doesn’t seem to be necessary in this type of surgery and could lead to more short-term issues. They recommend more targeted, well-designed studies to confirm these findings.

FAQs

  1. What are the two methods of surgery for gastric cancer mentioned in the research?
  2. What complications were found to be associated with the method that involves removing the spleen?
  3. Did the research find any significant difference in mortality rates or five-year survival rates between the two methods of surgery for gastric cancer?

Doctor’s Tip

A doctor may tell a patient who has undergone a splenectomy for gastric cancer to be extra vigilant about symptoms of infection, such as a fever, and to seek immediate medical attention if they experience any concerning symptoms. It is also important for the patient to stay up to date on vaccinations to help prevent infections, as the spleen plays a key role in the immune system. Additionally, the patient should be mindful of their overall health and well-being, including maintaining a healthy diet, regular exercise, and avoiding activities that may increase the risk of injury. Regular follow-up appointments with their healthcare provider are important to monitor for any potential long-term complications.

Suitable For

Patients who are typically recommended splenectomy include those with:

  1. Blood disorders such as hereditary spherocytosis, thalassemia, or autoimmune hemolytic anemia, where the spleen is involved in the destruction of red blood cells.
  2. Splenic tumors, such as splenic cysts, hemangiomas, or lymphomas, where the removal of the spleen is necessary to prevent further complications.
  3. Traumatic injuries to the spleen, such as a ruptured spleen due to a car accident or other trauma, where emergency splenectomy may be required to control bleeding.
  4. Certain types of cancers, such as Hodgkin’s lymphoma or certain types of leukemia, where the spleen may be involved in the spread of cancer cells.
  5. In some cases of severe infections, such as overwhelming sepsis or certain parasitic infections, where removal of the spleen may be necessary to prevent further spread of infection.

It is important for a healthcare provider to carefully assess each individual case and weigh the risks and benefits of splenectomy before recommending this type of surgery.

Timeline

Before splenectomy:

  1. Patient is diagnosed with a condition that requires splenectomy, such as a ruptured spleen, certain types of cancer, or certain blood disorders.
  2. Patient undergoes pre-operative evaluations and tests to assess their overall health and to prepare for surgery.
  3. Patient may receive vaccinations to prevent infections after splenectomy.
  4. Patient is informed about the risks and benefits of the surgery and gives consent for the procedure.

After splenectomy:

  1. Patient undergoes the surgical procedure to remove the spleen.
  2. Patient is closely monitored in the recovery room for any immediate complications.
  3. Patient may experience pain, discomfort, and fatigue in the days following the surgery.
  4. Patient is discharged from the hospital and continues to recover at home.
  5. Patient is at an increased risk for infections, particularly from encapsulated bacteria, and may require prophylactic antibiotics or vaccinations.
  6. Patient may need to make lifestyle changes, such as avoiding certain activities or foods that increase the risk of infection.
  7. Patient may need to follow up with their healthcare provider regularly to monitor for any long-term complications, such as blood clotting disorders or an increased risk of certain infections.

What to Ask Your Doctor

  1. What are the potential benefits of undergoing a splenectomy for my stomach cancer?
  2. What are the potential risks or complications associated with a splenectomy?
  3. How will a splenectomy affect my immune system and overall health in the long term?
  4. Are there alternative treatment options that do not involve removing the spleen?
  5. What is the recovery process like after a splenectomy compared to a surgery that preserves the spleen?
  6. Will I need any additional vaccinations or medications after a splenectomy to prevent infections?
  7. How will a splenectomy impact my quality of life and daily activities?
  8. What are the long-term implications of living without a spleen?
  9. Are there any specific follow-up care or monitoring that I will need after a splenectomy?
  10. Can you provide me with more information or resources to help me make an informed decision about undergoing a splenectomy for my stomach cancer?

Reference

Authors: Wang Q, Dang T, Meng X, Li K, Ren W, Ma X, Huang Y, Wu X, Han W, Zhang D, Li X, Wang D, Zheng L. Journal: Asia Pac J Clin Oncol. 2019 Apr;15(2):e28-e35. doi: 10.1111/ajco.13052. Epub 2018 Sep 4. PMID: 30178572