Our Summary

This research paper looks at the results of surgeries for gastric cancer, specifically whether it is more beneficial to remove the spleen (splenectomy or SP) or to keep it (splenic preservation). The researchers looked at multiple studies and trials, involving over 6,000 patients, to see if there were differences in survival rates and complications after the operations. They found that removing the spleen did not improve survival rates compared to keeping the spleen. They also discovered that surgeries involving spleen removal had more overall complications, like pancreatic fistula and intraabdominal abscesses. However, there were no significant differences in complications like intestinal obstruction, internal bleeding, and lung infection. There was also no significant difference in deaths after the operations. Therefore, they concluded that it was not necessary to routinely remove the spleen during surgery for gastric cancer.

FAQs

  1. Does removing the spleen improve survival rates in gastric cancer surgeries?
  2. Are there more complications in surgeries involving spleen removal compared to surgeries preserving the spleen?
  3. Is it necessary to routinely remove the spleen during surgery for gastric cancer?

Doctor’s Tip

One helpful tip a doctor might tell a patient about splenectomy is to be aware of the potential risks and complications involved in the procedure. It is important to discuss these risks with your doctor and weigh the potential benefits of spleen removal against the possible complications. Additionally, patients who have undergone a splenectomy should be diligent about receiving vaccinations to prevent infections, as the spleen plays a crucial role in the immune system. Regular follow-up appointments with your healthcare provider are also important to monitor for any potential complications or changes in health.

Suitable For

Patients who are typically recommended splenectomy include those with conditions that affect the spleen, such as splenic tumors, splenic abscesses, and certain blood disorders like hereditary spherocytosis and idiopathic thrombocytopenic purpura (ITP). In some cases, splenectomy may also be recommended for patients with trauma to the spleen or certain types of cancer, such as lymphoma. Additionally, splenectomy may be recommended for patients with certain autoimmune diseases, such as autoimmune hemolytic anemia or lupus, if other treatments have been ineffective. Ultimately, the decision to recommend splenectomy will depend on the individual patient’s specific condition and medical history.

Timeline

Before splenectomy:

  1. Patient is diagnosed with gastric cancer and undergoes various tests and evaluations to determine the extent of the cancer.
  2. Surgeon discusses treatment options, including the possibility of splenectomy.
  3. Patient undergoes pre-operative preparations, which may include blood tests, imaging scans, and medication adjustments.
  4. Surgery is scheduled and patient is informed of the risks and benefits of splenectomy.

After splenectomy:

  1. Patient undergoes the splenectomy procedure, which may be done laparoscopically or through open surgery.
  2. Patient is monitored closely in the hospital for any complications or side effects of the surgery.
  3. Patient may experience pain, fatigue, and discomfort in the days following the surgery.
  4. Patient may be prescribed medications to manage pain and prevent infections.
  5. Patient is discharged from the hospital and continues to recover at home, following post-operative care instructions.
  6. Patient may need to undergo follow-up appointments and tests to monitor their recovery and check for any potential complications.
  7. Patient may be advised to receive vaccinations to prevent infections due to the absence of the spleen.
  8. Patient may be counseled on lifestyle changes and precautions to take to maintain a healthy immune system without a spleen.

What to Ask Your Doctor

  1. What are the potential benefits of splenectomy for my specific condition?
  2. What are the potential risks and complications associated with splenectomy?
  3. How will removing my spleen affect my immune system and overall health?
  4. Are there alternative treatment options that do not involve splenectomy?
  5. What is the success rate of splenectomy for my condition?
  6. How long is the recovery period after splenectomy?
  7. Will I need any special vaccinations or medications after splenectomy to prevent infections?
  8. How will splenectomy affect my long-term health and quality of life?
  9. Are there any specific lifestyle changes or precautions I should take after splenectomy?
  10. Can you provide me with more information or resources about splenectomy and its implications for my condition?

Reference

Authors: Wang D, Ren J, Wang Y, Dong X, Liu S, Liao T, Zhu L, Yu M, Cai H. Journal: Postgrad Med. 2024 Apr;136(3):266-277. doi: 10.1080/00325481.2024.2333233. Epub 2024 Apr 3. PMID: 38567398