Spleen-preserving lymphadenectomy versus splenectomy in laparoscopic total gastrectomy for advanced gastric cancer

Sang Yong Son, Dong Joon Shin, Young Suk Park, Aung Myint Oo, Do Hyun Jung, Chang Min Lee, Sang Hoon Ahn, Do Joong Park, Hyung Ho Kim

Research output: Contribution to journalArticlepeer-review

26 Citations (Scopus)


Background To investigate the optimal approach for laparoscopic splenic hilum lymph node dissection in proximal advanced gastric cancer, we compared the operative outcomes between laparoscopic spleen-preserving total gastrectomy (sp-LTG) and laparoscopic total gastrectomy with splenectomy (sr-LTG). Methods A retrospective case-cohort study was conducted between February 2006 and December 2012. The operative outcomes, the number of retrieved splenic hilum lymph node, complication, and patients’ survivals were analyzed. Results 112 patients who underwent laparoscopic total gastrectomy with or without splenectomy for advanced gastric cancer were enrolled (68 sp-LTGs and 44 sr-LTGs). The mean operation time (227 min vs. 224 min, p = 0.762), estimated blood loss (157 ml vs. 164 ml, p = 0.817), and complication rate (17.6% vs. 13.6%, p = 0.572) were not different between two groups. Regarding splenic lymph node dissection, there were significantly differences in the mean number of retrieved lymph nodes between sp-LTG and sr-LTG (LN no.10; 1.78 vs. 3.21, p = 0.033, LN no.11d; 1.41 vs. 2.76, p = 0.004). The 5-year survivals were 77.3% in sp-LTG and 65.9% in sr-LTG (p = 0.240). The hazard ratio of splenectomy was 1.139 (95% confidence interval 0.514–2.526, p = 0.748). Conclusion In laparoscopic total gastrectomy for proximal advanced gastric cancer, spleen-preserving hilar dissection showed comparable short-term and long-term outcomes.

Original languageEnglish
Pages (from-to)207-211
Number of pages5
JournalSurgical Oncology
Issue number2
Publication statusPublished - 2017 Jun 1


  • Gastric cancer
  • Laparoscopy
  • Total gastrectomy

ASJC Scopus subject areas

  • Surgery
  • Oncology


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