Cellular and humoral changes after splenectomy

Abstract

The work is devoted to the human immune system and state of immunity in patients after gastrectomy with splenectomy for gastric cancer. The gold standard of gastric cancer treatment is the surgical method with the use of extended lymphodissection D2. Often with proximal and total involvement of stomach, the removed block includes the spleen for better radicality. In the world literature, however, no common view of the necessity of splenectomy exists as later such patients develop immunodeficiency which can further lead to different postoperative complications negatively affecting survival. There are few studies of immunological changes of patients with gastric cancer after gastrosplenectomy with extended lymphodissection D2. Immunological changes are poorly studied in different stages of patient management after such operative interventions: before the operation and at various stages after it. The article gives a brief analysis of the anatomical and physiological structure of the spleen - one of the important organs of the reticuloendothelial system. Great attention is paid to immunocompetent cells. The most important clinical studies on the subpopulations of cells and humoral factors of antiviral and antimicrobial mechanisms of protection in a healthy organism and in patients with OPSI-syndrome are analyzed in detail. The review presents the data on the influence of splenectomy in gastrectomy for gastric cancer on the development of postoperative complications as well as methods of treatment of complications associated with splenectomy, the use of immunostimulants, autolienotransplantation, methods of ligation of the splenic artery, and spleen-preserving lymphodissection.