Abstract
An 82-year-old man was seen at our hospital because of shortness of breath on effort. He was diagnosed as having type 3 gastric cancer by an upper gastrointestinal endoscopy and suspected lung cancer at the base of the right lung by a chest CT scan. Laboratory data on admission revealed thrombocytopenia, and he was diagnosed as having idiopathic thrombocytopenic purpura (ITP) as well. As the high dose intravenous gammaglobulin therapy failed to increase the platelet count, we performed operation after steroid therapy. Operative procedures included distal gastrectomy preserving the left gastric artery, D1+α lymph node dissection and splenectomy.
In the treatment of gastric cancer with ITP, we should consider the necessity of splenectomy case by case, and employ appropriate strategies for gastrectomy in accordance with the region involued in the cancer and the clinical stage. Distal gastrectomy and splenectomy can be performed safely by maintaing blood circulation in the remmant stomach. In this report, we also review the relevant literature, and consider preoperative management and surgical strategies for gastric cancer with ITP.
