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研究胃癌联合脾胰体尾切除术的适应证及远期疗效。方法：观察35例胃癌的大小、大体类型、生长方式、浆膜浸润程度、肿块至脾门的最近距离、4s、4d组淋巴结转移及其与脾门淋巴结转移的关系。并对50例胃癌病人联合脾胰体尾切除病例5年生存率与未行脾胰体尾切除的病例进行比较。结果：肿块距脾门最近距离≤5.0cm并呈浸润生长时，与脾门淋巴结转移呈极显著相关(P<0.01)，4s组淋巴结疑有转移癌或冰冻证实有癌转移时与脾门淋巴结呈显著相关(P<0.05)，胃癌联合脾胰体尾切除与非联合脾胰体尾切除根治术后，比较5年生存率无显著差异(P<0.05)。结论：肿块边缘距脾门的最近距离≤5.0cm、4s组淋巴结疑有转移或冰冻证实有癌转移、肿块呈浸润性生长并接近脾门时，脾门淋巴结极有可能转移，至少应行胃癌联合脾胰体尾切除手术，同时胃癌联合脾胰体尾切除手术并未降低胃癌术后的5年生存率，因此，可以将胃癌联合脾胰体尾切除手术的指征再进一步放宽。
To study the indications and long-term outcomes of gastric cancer combined with spleno-pancreatic body resection. METHODS: The size, general type, growth pattern, degree of serosal infiltration, distance from the tumor to the splenic portal, and lymph node metastasis in the 4s and 4d groups were observed in 35 cases of gastric cancer and their relationship with lymph node metastasis. The 50-year survival rate of 50 patients with gastric cancer combined with spleno-pancreatic body-tailectomy was compared with those without spleno-pancreatic body and tail-resection. RESULTS: When the tumor was ≤5.0 cm away from the splenic valve and showed infiltrating growth, it was significantly associated with lymph node metastasis of the splenic portal (P<0.01). The metastasis of the lymph node in the 4s group was suspected to have metastasis or lymph node metastasis. There was a significant correlation (P<0.05). There was no significant difference in 5-year survival rate after gastric cancer combined with spleno-pancreatic body-cuffectomy and non-combined spleno-pancreatic body-cuffectomy (P<0.05). CONCLUSIONS: When the proximal margin of the mass to the splenic orifice is less than or equal to 5.0 cm, the metastasis or freezing of the 4s lymph node is confirmed to have metastasis, infiltrative growth of the mass and proximity to the splenic portal, the lymph node of the splenic portal is likely to metastasize. The combined spleno-pancreatic body-tailectomy and simultaneous surgery for gastric cancer combined with spleno-pancreatic body and tail did not reduce the 5-year survival rate of postoperative gastric cancer. Therefore, the indications for combined surgery of gastric cancer and spleno-pancreatic body and tail can be further relaxed.