Early-stage outcomes of bursectomy in surgery of gastric cancer and radical gastric resection

Early-stage outcomes of bursectomy in surgery of gastric cancer and radical gastric resection

Aim: Bursectomy, mainly defined as a complete dissection of the peritoneal lining covering the anterior plane of the transverse mesocolon and the pancreas with an omentectomy during gastrectomy, has been performed for the serosa-positive gastric cancers. Recently, some researchers have interrogated whether bursectomy for gastric cancer is essential from a surgical point of view, thus, we aimed to investigate the short-term surgical and early-stage clinicopathological outcomes of bursectomy in the treatment of advanced gastric cancer patients by a single center study and retrospective controlled trial.Material and Methods: From January 2016 to December 2017, retrospective findings of selected 100 gastric cancer patients in advanced tumor stages and underwent D2 radical gastrectomy were grouped and analyzed in terms of bursectomy performed or not in Bakirkoy Dr. Sadi Konuk Training and Research Hospital.Results: In conclusion, 50 patients were in bursectomy (B) group and 50 patients in non-bursectomy (NB) group. Clinical features (age, gender, and gastrectomy pattern and tumor location) of both groups showed no statistically significant difference. Postoperative mortality rate were also similar of both groups (4%). All other post-operative complications were not significantly distinctive for two groups.Conclusions: Bursectomy may increase the surgical duration of D2 gastrectomy and but not early-stage outcomes and post-operative complications. Experienced surgeons can perform the procedure safely. However, long-term, large sample sized, and high-quality randomized controlled trials are needed for the survival benefits of bursectomy.

___

  • 1. Torre LA, Bray F, Siegel RL, et al. Global cancer statistics, 2012. CA Cancer J Clin 2015;65:87-108.
  • 2. Colquhoun A, Arnold M, Ferlay J, et al. Global patterns of cardia and non-cardia gastric cancer incidence in 2012. Gut 2015;64:1881-8.
  • 3. Chen W, Zheng R, Zeng H, et al. Annual report on status of cancer in China, 2011. Chin J Can-cer Res. 2015;27:2-12.
  • 4. Maruyama K, Okabayashi K, Kinoshita T. Progress in gastric cancer surgery in Japan and its limits of radicality. World J Surg 1987;11:418-25.
  • 5. Hagiwara A, Sawai K, Sakakura C, et al. Complete omentectomy and extensive lymphadenec-tomy with gastrectomy improves the survival of gastric cancer patients with metastases in the adjacent peritoneum. Hepatogastroenterology 1998;45:1922-9.
  • 6. Yoshikawa T, Tsuburaya A, Kobayashi O, et al. Is bursectomy necessary for patients with gastric cancer invading the serosa? Hepato-Gastroenterology 2004;51:1524-6.
  • 7. Fujita J, Kurokawa Y, Sugimoto T, et al. Survival benefit of bursectomy in patients with resec-table gastric cancer: interim analysis results of a randomized controlled trial. Gastric Cancer 2012; 15:42-8.
  • 8. Eom BW, Joo J, Kim YW, et al. Role of bursectomy for advanced gastric cancer: result of a case–control study from a large volume hospital. Eur J Surg Oncol 2013;39:1407-14.
  • 9. Kochi M, Fujii M, Kanamori N, et al. D2 gastrectomy with versus without bursectomy for gas-tric cancer. Am J Clin Oncol 2014;37:222-6.
  • 10. Shen WS, Xi HQ, Wei B, et al. Effect of gastrectomy with bursectomy on prognosis of gastric cancer: a meta-analysis. World J Gastroenterol 2014;20:14986-91.
  • 11. Japanese classification of gastric carcinoma: 3rd English edition. Gastric Cancer 2011;14:101-12.
  • 12. Japanese gastric cancer treatment guidelines 2010 (ver. 3). Gastric Cancer 2011;14:113-23.
  • 13. Washington K. 7th edition of the AJCC cancer staging manual: stomach. Ann Surg Oncol 2010;17:3077-9.
  • 14. Kurokawa Y, Doki Y, Mizusawa J, et al. Bursectomy versus omentectomy alone for resectable gastric cancer (JCOG1001): a phase 3, open-label, randomised controlled trial. Lancet Gastro-enterol Hepatol 2018;3:460-8.
  • 15. Imamura H, Kurokawa Y, Kawada J, et al. Influence of bursectomy on operative morbidity and mortality after radical gastrectomy for gastric cancer: results of a randomized controlled trial. World J Surg 2011;35:625-30.
  • 16. Hirao M, Kurokawa Y, Fujita J, et al. Longterm outcomes after prophylactic bursectomy in pa-tients with resectable gastric cancer: final analysis of a multicenter randomized controlled tri-al. Surgery. 2015.
  • 17. Zhang WH, Chen XZ, Yang K, et al. Bursectomy and non-bursectomy D2 gastrectomy for ad-vanced gastric cancer, initial experience from a single institution in China. World J Surg Oncol 2015;13:332.
  • 18. Blouhos K, Boulas KA, Hatzigeorgiadis A. Metastasis in lymph nodes on the anterior pancreatic surface of the body and tail: an extremely rare finding during bursectomy in extended surgery for gastric cancer. Updates Surg 2015;67:97-8.
  • 19. Herbella FA, Tineli AC, Wilson Jr JL, et al. Gastrectomy and lymphadenectomy for gastric can-cer: is the pancreas safe? J Gastrointest Surg 2008;12:1912-4.
Annals of Medical Research-Cover
  • Yayın Aralığı: Aylık
  • Yayıncı: İnönü Üniversitesi Tıp Fakültesi