Differential effects of radical D2-lymphadenectomy and splenectomy in surgically treated gastric cancer patients.

Background/aims: Radical surgery with extended lymph node dissection (D2-LA) is the treatment of choice for gastric cancer patients in Japan. In Western countries results after D2-LA are controversially discussed, as increased D2-LA related complications are reported. The aim of this retrospective study was to analyze the influence of D2-LA and/or splenectomy on the clinical course, morbidity and long-term survival of gastric cancer patients.

[Gastrectomy with radical D2 lymph node excision--effective and economically standardized therapy of adenocarcinoma of the stomach].

In a retrospective single center study, the impact of radical D2-lymph adenectomy and splenectomy on operativ course, morbidity, mortality and long-term survival, in 243 patients who underwent radical surgical therapy for gastric cancer, was analyzed. D2-lymph node dissection during gastrectomy or gastric resection did not influence blood loss, artificial respiration time, ICU days or surgical morbidity, whereas splenectomy correlated with a higher hospital mortality, leakage and abscess rate. Due to routinely performed D2-lymphadenectomy long term survival rate (5 years) was 40.

[Significant value and therapeutic implications of routine gastroscopy before cholecystectomy].

Endoscopy of the upper digestive tract was performed in 338 consecutive patients undergoing cholecystectomy between January 1991 and December 1992. Pathological findings were seen in 160 (47.3%), 6.

Sepsis syndrome induced by tuberculous perforation of the esophagus.

Perforation of the esophagus induced by tuberculosis with no evidence of HIV infection is an extremely unusual presentation of the disease. We report on a 41-year-old man presenting with an esophageal perforation who developed a sepsis syndrome characterized by multiple organ dysfunction. The perforation was covered endoscopically with a tube, the patient recovered from cardiovascular, renal and pulmonary dysfunction under intensive care treatment, including antimycobacterial therapy.