Effect of spleen preservation on immune function in patients with adenocarcinoma of gastroesophageal junction undergoing palliative total gastrectomy
WU Qianfu
LI Junhua
LIN Zhenhai
ZHANG Zhidong
WEI Hailong
Abstract：Objective To investigate the effect of spleen preservation on immune function in patients with adenocarcinoma of gastroesophageal junction undergoing palliative total gastrectomy.Methods Ninety-eight cases of patients with adenocarcinoma of gastroesophageal junction were selected, who were treated in hospital from October 2012 to October 2014, and they were divided into the observation group (52 cases) and control group (46 cases) according to whether the spleen was retained or not.The patients of observation group were treated with palliative total gastrectomy and spleen retention, while the patients of control group were treated with palliative total gastrectomy and splenectomy.The operation and postoperative follow up of 1 to 24 months of survival and changes of the levels of immunoglobulin (IgA, IgG, IgM) and T lymphocyte subsets (CD3+,CD4+,CD8+) of two groups were compared.Results The operation time, intraoperative blood loss, gastrointestinal function recovery time and fluid diet time of the observation group were significantly lower than those of the control group (P<0.05);The levels of IgA, IgG, IgM, CD3+,CD4+ and CD4+/CD8+ in the two groups were significantly higher than before on the 10th postoperative day (P<0.05);There were no significant changes in IgA, IgG, IgM,CD3+,CD4+,CD+4/CD8+ levels in the observation group at 1 month after operation compared to the 10th postoperative day (P>0.05), while the levels of IgA, IgG, IgM, CD3+,CD4+,CD4+/CD8+ recovered to preoperative levels in the control group, the difference was statistically significant(t=3.206,t=6.243,t=3.809,t=3.705,t=2.707,t=2.342,P＜0.05);After follow up of 1 to 24 months (median follow up of 16.3months), the one year survival rate was 42.1% in the observation group and 39.3% in the control group, there was no significant difference between the two groups (X2=0.084,P=0.773).Conclusion The patients with adenocarcinoma of gastroesophageal junction undergoing palliative total gastrectomy should retain the spleen, which is beneficial to improve the immune function, and has a certain clinical significance for postoperative prognosis.
Keywords：Adenocarcinoma of gastroesophageal junctionPalliative total gastrectomySpleen preservationImmune function
Publication Date：2017-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 694-697 )