Factors Affecting Morbidity and Mortality in Gastrectomy Cases with Splenectomy

Abstract

Gastric cancer is a worldwide health problem. The addition of splenectomy to gastrectomy is a controversial issue, especially in cases located on the greater curvature. In this study, it is aimed to find the factors affecting morbidity and mortality in gastrectomy cases with splenectomy. Patients who underwent surgery for gastric cancer in Van Yuzuncu Yil University, Department of General Surgery between January 2010 and January 2018 were retrospectively selected. Splenectomy cases were filtered out in all gastrectomy patients. Preoperative, intraoperative and postoperative data of the patients were collected. The effects of the collected parameters on morbidity and mortality were evaluated. A p value of less than 0.05 was considered statistically significant. 45 patients were included in the study. The mean age of all patients was 64.2 years (32-85) and the male to female ratio was 27/18. Thirty seven cases (82.2%) were operated under elective conditions. The most common tumor location was cardia (n=24, 53.3%) and the most common surgical method (n=39) was total gastrectomy (86.7%). Morbidity and mortality rate of the study were 46.6% (n=21) and 17.8% (n=8), respectively. Mortality increased in patients who were operated in emergency conditions and received neoadjuvant therapy, p=0.002 and P=0.044, respectively. While surgery under emergency conditions increased mortality, preoperative neoadjuvant treatment decreased mortality. However, there was no factor affecting morbidity. Splenectomy in gastric cancer surgery, if possible, should be performed under elective conditions and after neoadjuvant therapy to reduce mortality.