The role of splenectomy in the surgery of the cancer of the body and the proximal part of the stomach

The results of 155 operations with D2 lymphodissection without splenectomy, performed in RONC in 2005-2012, are presented. The control group consisted of 197 patients after standard D2 gastrectomy with splenectomy. Immunological status was assessed in 45 patients: the number of 2 CD3+, CD4+, CD4+/CD8+ lymphocytes, the main classes of immunoglobulins, decreased. Operations with D2 lymphadissection without splenectomy led to an increase in the duration of the operation by an average of 20 minutes, contributed to a decrease in intraoperative blood loss and the incidence of complications (sub-diaphragmatic abscess and pancreatic fistula), and a decrease in hospital stay. The indicator of three-year survival rate (according to Kaplan-Meier) was 80.9% in the main group and 62.9% in the control group (p=0.01). An operation with D2 lymphadenectomy without splenectomy can be considered as a radical and safe surgical method for locally advanced carcinoma of the body and proximal stomach.