1991 Fiscal Year Final Research Report Summary
Splenic autotransplantation following total gastrectomy with splenectomy for gastric cancer
| Project/Area Number |
62570622
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| Research Category |
Grant-in-Aid for General Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Research Field |
Digestive surgery
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| Research Institution | Kansai Medical University |
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Principal Investigator |
NAKANE Yasushi Department of Surgery, Kansai Medical University, Lecture, 医学部, 講師 (60155778)
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| Co-Investigator(Kenkyū-buntansha) |
HAMADA Yoshinori Department of Surgery, Kansai Medical University, Assistant, 医学部, 助手 (00172982)
YAMAMURA Manabu Department of Surgery, Kansai Medical University, Lecturer, 医学部, 講師 (60077732)
HIOKI Koshiro Department of Surgery, Kansai Medical University, assistant professor, 医学部, 助教授 (60077641)
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| Project Period (FY) |
1987 – 1989
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| Keywords | Total gastrectomy with splenectomy for gastric cencer / Splenic autotransplantation / 脾自家移植 |
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| Research Abstract |
In traumatized patients who require splenectomy, autotransplantation of the removed spleen has been suggested as a means of preserving immunologic function. However, clinical application of this procedure has been limited due to fear of implant-related complications. In cases of advanced cancer of the upper and middle stomach, splenectomy is frequently done because of complete removal of the lymph nodes at the splenic hilus. To clarify the effectiveness of splenic autotransplantation into patients with gastric cancer, we observed complications as well as changes of serum factors associated with splenic function in such patients and compared these results with those in a control group. Patients with gastric cancer at stages II and III who underwent total gastrectomy with combined splenectomy were divided into the following two groups : 10 patients who underwent splenectomy (control group), and 9 patients who also received splenic autotransplantation (splenectomy+splenic autotransplantation group). Splenic autotransplantation was performed according to Kusminsky's method ; about 30-40% of the total volume of the spleen was sliced into 1. OX1. OX0.5cm sections and implanted into mesenteric pockets and sewed in place. There was no serious complications after splenic implantation. Of 8 patients who underwent ^<99m>Tc-Labeled heated red blood cell scintigram, 6 (75%) demonstrated positive findings. There were no significant differences between the group in changes of platelet count, blood lymphocyte count, immunoglobulin activity (IgG, IgA and IgM) or serum cell-mediated immunity activity (OKT_3, OKT_4, OKT_8, OKT_4/OKT_8, and NK activity). In conclusion, although further cases and studies of regenerated splenic function are needed, we consider this procedure to be a reasonable redical operation for patients with advanced cancer of the upper and middle stomach.
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