To investigate the short-term and long-term efficacy of splenectomy and splenic preservation in radical resection of proximal gastric cancer.

the data of 43 patients who underwent laparoscopic radical gastrectomy for gastric cancer from January 2012 to June 2014 were retrospectively analyzed. According to the different operation methods, the patients were divided into the spleen-preserving group (20 cases) and the spleen-cutting group (23 cases). Statistical software SPSS 24.0 was used for data analysis. Indicators and number of No.10 and No.11 lymph nodes dissected during the perioperative period were expressed as (±s), and independent sample t test was used. Postoperative complications between groups were compared by χ² test. The kaplan-meier curve of 1-year, 3-year and 5-year overall survival rate and disease-free survival rate of the two groups was drawn for log-rank detection. P<0.05 indicated that the difference was statistically significant.

All patients of two groups successfully completed the operation, no conversion to laparotomy, no postoperative death in hospital, all completed follow-up. There was no significant difference in the time of operation, the amount of bleeding during operation, the time of anal exhaust, the number of lymph node dissection and the number of No.10 and No.11 lymph node dissection (P>0.05); the incidence of complications in the group of spleen preservation (7 cases, 35.0%) was significantly lower than that in the group of spleen resection (15 cases, 65.2%) (P<0.05). The 1-year, 3-year and 5-year overall survival rates of patients in the spleen group were 80.0%, 45.0% and 40.0%, respectively, and those in the spleen cutting group were 82.6%, 47.8% and 39.1%, respectively, with no statistical difference between the two groups (P>0.05); the 1-year, 3-year and 5-year disease-free survival rates of patients in the spleen protecting group were 75.0%, 45.0% and 35.0%, respectively, and those in the spleen cutting group were 78.3%, 43.5% and 34.8%, respectively, with no statistical difference between the two groups (P>0.05).

Compared with the effect of splenectomy and spleen preservation in the radical operation of advanced proximal gastric cancer, the latter has a faster recovery and a lower incidence of complications.And they havethe same effect in lymph node dissection and the same long-term prognosis.