Abstract
Nineteen cases of gastric carcinoma undergoing total gastrectomy were allocated at random to splenectomy group (10 cases) and splenectomy with splenic autotransplantation group (9), and the spleen graft survival, its regeneration, and the usefulness of the autotransplantation were determined in terms of serological factors. In the transplantation, 30%-40% of the spleen by weight was made into small tissue fragments and diffusely transplanted in the mesenteries of the transverse colon and small intestine. No severe postoperative complications were seen. In splenic scintigram using 99m Tc-heat treated erythrocytes, 6 (75%) out of 8 cases under follow-up for 3 months or more showed positive findings. There was no significant difference between both groups in postoperative changes in platelet counts, immunoglobulin, cellular immune parameters such as T3, T4, T8, T4/T8, and NK activity. No clear resolution was given for effects of splenic transplantation on serological factors. However, this operative procedure was able to satisfy the radicalness in operation for gastric carcinoma, and to provide the regeneration of the spleen. It is indicated that this procedure, consisting of total gastrectomy, splenectomy and splenic transplantation, can be a possible candidate for radical operation for gastric carcinoma.
