Abstract
To evaluate the significance of omento-bursectomy for T2 and T3 gastric cancers, a retrospective study was carried out. A series of 787 patients with gastric cancer who underwent gastrectomy in our hospital from 1991 to 2001 were enrolled in the study and divided into two groups; omentum and bursa preserving gastrectomy group (Preserving group: PG) and gastrectomy with resection of the omentum and brusa (Resection group: RG). Several clinical factors, such as survival rate, operation time, blood loss volume, postoperative hospital stay, postoperative complications and recurrence mode, were compared between PG and RG. The 5-year survival rates in T2PG and T2RG were 85.4% and 74.6% (p=0.003), and those in T3PG and T3RG were 60.2% and 50.5% (p=0.24), respectively. Rates of peritoneal recurrence in T2PG and T2RG were 2.4% and 5.0% (p=0.22), and those in T3PG and T3RG were 10.0% and 23.2% (p=0.15), respectively. No survival benefit of omento-bursectomy was observed, and prophylactic effect of the procedure for peritoneal recurrence could not be expected. But significantly less operation time, blood loss volume, postoperative hospital stay were noted in PG than RG. The incidence of postoperative complications including postoperative pancreatitis and ileus was also less in PG. In conclusion, omentum and bursa preserving gastrectomy is a reasonable procedure for T2 or T3 gastric cancer patients.
