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- Title
Impact of splenectomy on surgical outcome in patients with cancer of the distal esophagus and gastro-esophageal junction.
- Authors
Pultrum, B. B.; Van Bastelaar, J.; Schreurs, L. M. A.; Van Dullemen, H. M.; Groen, H.; Nijsten, M. W. N.; Van Dam, G. M.; Plukker, J. T. H. M.
- Abstract
We aim to determine the effect of splenectomy on clinical outcome in patients with cancer of the distal esophagus and gastro-esophageal junction (GEJ) after a curative intended resection. From January 1991 to July 2004, 210 patients underwent a potentially curative gastroesophageal resection with an extended nodal dissection. The study group was divided into: group I with splenectomy, consisting of 66 patients (31.4%), and group II without splenectomy, of 144 patients. Splenectomy was performed for oncological reasons. Medical records were reviewed retrospectively. Postoperative complications occurred in 27 patients (40.9%) in group I and in 68 patients (47.2%) in group II ( P = 0.4). The overall mortality was not significantly different between both groups ( P = 0.7). There was a higher administration of red blood cells during surgery ( P ≤ 0.001), increased operating room (OR) time ( P ≤ 0.001) and longer intensive care unit (ICU) stay ( P = 0.01) in group I. Independent prognostic factors for survival were outcome of surgery, nodal metastases, gender, complications and ICU stay. Sepsis was a strong prognostic factor among the complications. The 1 and 2-year survival was significantly higher in group II; 75% and 67% ( P = 0.032) compared to 69% and 56% ( P = 0.017) in group I, respectively. However, the 5-year survival was not different in both groups (29% in group I and 60% in group II, P = 0.191). Splenectomy had no marked effect on mortality and morbidity after curative resection of esophageal cancer. Splenectomy had a significant increase in blood transfusions with prolonged OR time and ICU stay and decreased short-term survival.
- Subjects
CANCER patients; SURGICAL excision; ESOPHAGEAL cancer; SPLENECTOMY; SPLEEN surgery
- Publication
Diseases of the Esophagus, 2008, Vol 21, Issue 4, p334
- ISSN
1120-8694
- Publication type
Article
- DOI
10.1111/j.1442-2050.2007.00762.x