This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (15)  • Contact me when this article is cited  Related Content  • Related article  • Similar articles in this journal  Topic Collections  • Gastrointestinal/ Upper Foregut  • Alert me on articles by topic  Social Bookmarking   What's this?

Giovanni Battista Doglietto, MD; Fabio Pacelli, MD; Paola Caprino, MD; Maurizio Bossola, MD; Carmine Di Stasi, MD

Arch Surg. 2000;135:89-92.

Background  Pancreas-preserving total gastrectomy for gastric cancer has been proposed to remove lymph nodes along the upper border of the pancreas without performing a distal pancreatic resection. However, the original technique includes the ligation of the splenic artery at its origin and thus carries the risk of pancreatic necrosis.

Hypothesis  A technique of pancreas-preserving total gastrectomy that includes ligation of the splenic artery approximately 5 cm distally from the root may reduce the risk of postoperative pancreatic necrosis.

Design  Case series.

Setting  Both primary and referral hospital care.

Patients  Hospital records of 228 consecutive patients who, according to a personal technique, underwent D3 pancreas-preserving total gastrectomy for gastric cancer from 1981 to 1997 were reviewed.

Main Outcome Measures  Surgical complications, postoperative deaths, and survival.

Results  Hospital morbidity and mortality were 33.3% and 3.9%, respectively. No patients experienced pancreatic necrosis. The 5-year survival rate after curative resection was 53.6%: 96.9% for stage IA, 76.3% for stage IB, 63.0% for stage II, 35.6% for stage IIIA, 27.0% for stage IIIB, and 20.3% for stage IV (N3-positive patients) disease.

Conclusion  Results of the present study show the efficacy of this method of radical resection for gastric cancer as demostrated by the low incidence of postoperative complications and high survival rates.

From the Departments of Digestive Surgery (Drs Doglietto, Pacelli, Caprino, and Bossola) and Radiology (Dr Stasi), Catholic University, Rome, Italy.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati     What's this?

RELATED ARTICLE

Archives of Surgery Reader's Choice: Continuing Medical Education
Arch Surg. 2000;135(1):109-110.
FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Total Gastrectomy--Reply
Pacelli et al.
Arch Surg 2009;144:290-290.
FULL TEXT  

Four Hundred Consecutive Total Gastrectomies for Gastric Cancer: A Single-Institution Experience
Pacelli et al.
Arch Surg 2008;143:769-775.
ABSTRACT | FULL TEXT  

Nasojejunal Tube Placement After Total Gastrectomy: A Multicenter Prospective Randomized Trial
Doglietto et al.
Arch Surg 2004;139:1309-1313.
ABSTRACT | FULL TEXT