J Korean Surg Soc.  2009 Mar;76(3):154-158. 10.4174/jkss.2009.76.3.154.

Following of the Omentum Preserving Gastrectomy for Advanced Gastric Cancer without Serosa Exposure

• Kim JH
• Kang SH
• Oh ST
• Yook JH
• Kim BS
• Park KC

• KMID: 2096537
• DOI: http://doi.org/10.4174/jkss.2009.76.3.154

Abstract

PURPOSE
The generally accepted standard surgery for advanced gastric cancer is gastrectomy with D2 dissection accompanied by omentectomy. Theoretically, advanced gastric cancer without serosa exposure cannot disseminate metastasis to the omentum. However, the significance of routine omentectomy in survival remains unproved.
METHODS
From January 2000 to December 2002, 174 patients, who diagnosed T2 gastric adenocarcinoma pathologically, underwent curative gastrectomy by one operator. 52 patients underwent omentum-preserving gastrectomy and 122 patients underwent gastrectomy with resection of omentum. We compared clinicopathologic characteristics, recurrence patterns, recurrence rate and survival rates between the two groups.
RESULTS
Five-year survival rate was 82.9% in the omentum-preserving group and 85.2% in the omentectomy group (P=0.729). Moreover, there was no significant difference in recurrence rate between the two groups (P=0.298). In the omentum-preserving group, 3 peritoneal (25%), 4 local (33.3%), 4 hematogenous (33.3%), 1 distant lymph node (8.3%) recurrences were shown. However, in the omentectomy group, 7 peritoneal (35%), 6 local (30%), 6 hematogenous (30%), 1 distant lymph node (5%) recurrences were shown (P=0.935).
CONCLUSION
These results suggest that the omentum-preserving gastrectomy may be applicable to advanced gastric cancer without serosa exposure, and that it is not necessary to perform uniform omentectomy for all advanced gastric cancer.

Keyword

Omentum preserving gastrectomy; Omentectomy; Advanced gastric cancer

MeSH Terms

Adenocarcinoma
Gastrectomy
Humans
Lymph Nodes
Neoplasm Metastasis
Omentum
Recurrence
Serous Membrane
Stomach Neoplasms
Survival Rate

Figure

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  Fig. 1 Survival distributions of Omentum-preserving gastrectomy and gastrectomy with omentectomy.

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