Spleen-preserving D-2-lym-phodissection in hysterocarcinoma and proximal stomach
To develop the method of spleen-preserving lymphodissection in cancer of proximal part and body of stomach, to estimate its radicality and safety. 143 spleen-preserving D-2-lymphodissection procedures were performed. The control consisted of 182 patients after standard D-2-gastrectomies with splenectomy. The average number of all devitalized lymphatic nodes and lymphatic nodes in gates of spleen in comparable groups did not differ (33.8 and 29.4; 2.6 and 2.4). The results of performed spleen-preserving D-2-lymphodissection led to increase of the length of operation for about 20 min. However, it improved intraoperative decrease of blood loss, frequency of such complications as subdiaphragmatic abscess and pancreatic fistula and the length of stay in hospital. Kaplan-Meier three-year survival index was 80.9% in the main group, 62.9% in the control (p=0.01). Conclusion. Spleen-preserving D-2-lymphodissection can be considered as radical and safe surgical method in regional cancer and proximal stomach.