2019, Number 2
<< Back Next >>
Rev Invest Clin 2019; 71 (2)
Bursectomy in Gastric Cancer Surgery: A Meta-Analysis
Li Y, Li Y, Wang K
Language: English
References: 22
Page: 98-105
PDF size: 110.29 Kb.
ABSTRACT
Background: Bursectomy consists of surgically removing the peritoneal lining covering the pancreas and the anterior plane of
the transverse mesocolon during gastrectomy. However, there are little data to indicate whether bursectomy has a clinical
benefit.
Objective: The objective of this study was to study the effect of bursectomy on complications, recurrence, and overall
survival of patients with gastric cancer.
Methods: The publicly available literature published from January 2000 to July 2017
concerning gastrectomy with bursectomy and standard gastrectomy for gastric cancer was retrieved by searching the national
and international online databases. Meta-analysis was performed after the data extraction process.
Results: Eight studies were
finally included for a total of 1644 patients, of whom 644 underwent bursectomy and 1000 received standard gastrectomy
without bursectomy. As shown by the meta-analysis results, there were no statistically significant differences in the presence
of total post-operative complications (odds ratio [OR] = 1.06, 95% confidence interval [CI] [0.83-1.35],
p = 0.63), overall recurrence
(OR = 1.07, 95% CI [0.77-1.50],
p = 0.68), 3-year overall survival (OR = 1.30, 95% CI [0.82-2.07],
p = 0.26), and
5-year overall survival (OR = 0.91, 95% CI [0.66-1.27],
p = 0.58).
Conclusion: Although application of bursectomy in radical
gastrectomy did not increase post-operative complications, it offered no benefit to control tumor recurrence or improve overall
survival.
REFERENCES
Hagiwara A, Sawai K, Sakakura C, et al. Complete omentectomy and extensive lymphadenectomy with gastrectomy improves the survival of gastric cancer patients with metastases in the adjacent peritoneum. Hepatogastroenterology. 1998;45:1922-9.
Japanese Gastric Cancer Association. Japanese gastric cancer treatment guidelines 2010 (ver. 3). Gastric Cancer. 2011;14: 113-23.
Kayaalp C, Piskin T, Olmez A. Complications of bursectomy after radical gastrectomy for gastric cancer. World J Surg. 2012; 36:229.
Hirao M, Kurokawa Y, Fujita J, et al. Long-term outcomes after prophylactic bursectomy in patients with resectable gastric cancer: final analysis of a multicenter randomized controlled trial. Surgery. 2015;157:1099-105.
Shen WS, Xi HQ, Wei B, Chen L. Effect of gastrectomy with bursectomy on prognosis of gastric cancer: a meta-analysis. World J Gastroenterol. 2014;20:14986-91.
Jadad AR, Moore RA, Carroll D, et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials. 1996;17:1-12.
Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analysis. Eur J Epidemiol. 2010;25:603-5.
Hasegawa S, Kunisaki C, Ono H, et al. Omentum-preserving gastrectomy for advanced gastric cancer: a propensity-matched retrospective cohort study. Gastric Cancer. 2013;16:383-8.
Fujita J, Kurokawa Y, Sugimoto T, et al. Survival benefit of bursectomy in patients with resectable gastric cancer: interim analysis results of a randomized controlled trial. Gastric Cancer. 2012;15:42-8.
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.
Kochi M, Fujii M, Kanamori N, et al. D2 gastrectomy with versus without bursectomy for gastric cancer. Am J Clin Oncol. 2014; 37:222-6.
Zhang WH, Chen XZ, Yang K, et al. Bursectomy and non-bursectomy D2 gastrectomy for advanced gastric cancer, initial experience from a single institution in China. World J Surg Oncol. 2015;13:332.
Shchepotin I, Kolesnik O, Lukashenko A, Rozumiy D, Burlaka A. D2 gastrectomy with versus without bursectomy for gastric cancer: result of single center randomized trial. Ann Oncol. 2013;24: iv65.
Sasako M, McCulloch P, Kinoshita T, Maruyama K. New method to evaluate the therapeutic value of lymph node dissection for gastric cancer. Br J Surg. 1995;82:346-51.
Ziqiang W, Feng Q, Zhimin C, et al. Comparison of laparoscopically assisted and open radical distal gastrectomy with extended lymphadenectomy for gastric cancer management. Surg Endosc. 2006;20:1738-43.
de Aretxabala X, Konishi K, Yonemura Y, et al. Node dissection in gastric cancer. Br J Surg. 1987;74:770-3.
Herbella FA, Tineli AC, Wilson JL Jr, Del Grande JC. Gastrectomy and lymphadenectomy for gastric cancer: is the pancreas safe? J Gastrointest Surg. 2008;12:1912-14.
Macdonald JS, Smalley SR, Benedetti J, et al. Chemoradiotherapy after surgery compared with surgery alone for adenocarcinoma of the stomach or gastroesophageal junction. N Engl J Med. 2001;345:725-30.
Hagiwara A, Takahashi T, Sawai K, et al. Milky spots as the implantation site for malignant cells in peritoneal dissemination in mice. Cancer Res. 1993;53:687-92.
Yamamura Y, Ito S, Mochizuki Y, Nakanishi H, Tatematsu M, Kodera Y. Distribution of free cancer cells in the abdominal cavity suggests limitations of bursectomy as an essential component of radical surgery for gastric carcinoma. Gastric Cancer. 2007;10:24-8.
Yoshikawa T, Tsuburaya A, Kobayashi, et al. Is bursectomy necessary for patients with gastric cancer invading the serosa? Hepatogastroenterology. 2004;51:1524-6.
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.