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Bursectomy and non-bursectomy D2 gastrectomy for advanced gastric cancer, initial experience from a single institution in China

BACKGROUND: The aim of this study is to evaluate the safety and efficacy of bursectomy of D2 gastrectomy in terms of postoperative complications and short-term survival outcomes. METHODS: From January 2012 to December 2013, data of 406 gastric cancer patients with advanced tumor stages and who under...

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Autores principales: Zhang, Wei-Han, Chen, Xin-Zu, Yang, Kun, Liu, Kai, Chen, Zhi-Xin, Zhang, Bo, Zhou, Zong-Guang, Hu, Jian-Kun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4672481/
https://www.ncbi.nlm.nih.gov/pubmed/26643472
http://dx.doi.org/10.1186/s12957-015-0744-x
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author Zhang, Wei-Han
Chen, Xin-Zu
Yang, Kun
Liu, Kai
Chen, Zhi-Xin
Zhang, Bo
Zhou, Zong-Guang
Hu, Jian-Kun
author_facet Zhang, Wei-Han
Chen, Xin-Zu
Yang, Kun
Liu, Kai
Chen, Zhi-Xin
Zhang, Bo
Zhou, Zong-Guang
Hu, Jian-Kun
author_sort Zhang, Wei-Han
collection PubMed
description BACKGROUND: The aim of this study is to evaluate the safety and efficacy of bursectomy of D2 gastrectomy in terms of postoperative complications and short-term survival outcomes. METHODS: From January 2012 to December 2013, data of 406 gastric cancer patients with advanced tumor stages and who underwent D2 radical gastrectomy and were grouped according to whether bursectomy was performed or not in West China Hospital, Sichuan University, were analyzed. RESULTS: Finally, 159 patients were in bursectomy group and 247 patients in non-bursectomy group. Surgical duration was 260.1 ± 43.4 min in the bursectomy group, compared to 227.9 ± 48.6 min in the non-bursectomy group (p < 0.001). The intraoperative blood loss was comparable between the bursectomy group and the non-bursectomy group (198.9 ± 63.5 vs. 201.1 ± 53.7 ml, p = 0.729). Postoperative morbidity rate showed no significant difference between the two groups, which were 23.3 % in the bursectomy group and 17.8 % in the non-bursectomy group, p = 0.179. The overall survival outcomes of patients were compared between the two groups of all patients (p = 0.055): patients who underwent distal gastrectomy (p = 0.129) and total gastrectomy (p = 0.016) and pT2-3 stage patients (p = 0.117) and pT4a stage patients (p = 0.128). The multivariate survival analysis identified that bursectomy or not, pT stage and pN stage were independent prognostic risk factors for the overall survival. CONCLUSIONS: The bursectomy might increase the surgical duration when the D2 gastrectomy was done. Experienced surgeons can perform it safely. However, for the survival benefits of bursectomy, long-term, large sample sized, and high-quality randomized controlled trials are expected. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12957-015-0744-x) contains supplementary material, which is available to authorized users.
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spelling pubmed-46724812015-12-09 Bursectomy and non-bursectomy D2 gastrectomy for advanced gastric cancer, initial experience from a single institution in China Zhang, Wei-Han Chen, Xin-Zu Yang, Kun Liu, Kai Chen, Zhi-Xin Zhang, Bo Zhou, Zong-Guang Hu, Jian-Kun World J Surg Oncol Research BACKGROUND: The aim of this study is to evaluate the safety and efficacy of bursectomy of D2 gastrectomy in terms of postoperative complications and short-term survival outcomes. METHODS: From January 2012 to December 2013, data of 406 gastric cancer patients with advanced tumor stages and who underwent D2 radical gastrectomy and were grouped according to whether bursectomy was performed or not in West China Hospital, Sichuan University, were analyzed. RESULTS: Finally, 159 patients were in bursectomy group and 247 patients in non-bursectomy group. Surgical duration was 260.1 ± 43.4 min in the bursectomy group, compared to 227.9 ± 48.6 min in the non-bursectomy group (p < 0.001). The intraoperative blood loss was comparable between the bursectomy group and the non-bursectomy group (198.9 ± 63.5 vs. 201.1 ± 53.7 ml, p = 0.729). Postoperative morbidity rate showed no significant difference between the two groups, which were 23.3 % in the bursectomy group and 17.8 % in the non-bursectomy group, p = 0.179. The overall survival outcomes of patients were compared between the two groups of all patients (p = 0.055): patients who underwent distal gastrectomy (p = 0.129) and total gastrectomy (p = 0.016) and pT2-3 stage patients (p = 0.117) and pT4a stage patients (p = 0.128). The multivariate survival analysis identified that bursectomy or not, pT stage and pN stage were independent prognostic risk factors for the overall survival. CONCLUSIONS: The bursectomy might increase the surgical duration when the D2 gastrectomy was done. Experienced surgeons can perform it safely. However, for the survival benefits of bursectomy, long-term, large sample sized, and high-quality randomized controlled trials are expected. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12957-015-0744-x) contains supplementary material, which is available to authorized users. BioMed Central 2015-12-08 /pmc/articles/PMC4672481/ /pubmed/26643472 http://dx.doi.org/10.1186/s12957-015-0744-x Text en © Zhang et al. 2015 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Zhang, Wei-Han
Chen, Xin-Zu
Yang, Kun
Liu, Kai
Chen, Zhi-Xin
Zhang, Bo
Zhou, Zong-Guang
Hu, Jian-Kun
Bursectomy and non-bursectomy D2 gastrectomy for advanced gastric cancer, initial experience from a single institution in China
title Bursectomy and non-bursectomy D2 gastrectomy for advanced gastric cancer, initial experience from a single institution in China
title_full Bursectomy and non-bursectomy D2 gastrectomy for advanced gastric cancer, initial experience from a single institution in China
title_fullStr Bursectomy and non-bursectomy D2 gastrectomy for advanced gastric cancer, initial experience from a single institution in China
title_full_unstemmed Bursectomy and non-bursectomy D2 gastrectomy for advanced gastric cancer, initial experience from a single institution in China
title_short Bursectomy and non-bursectomy D2 gastrectomy for advanced gastric cancer, initial experience from a single institution in China
title_sort bursectomy and non-bursectomy d2 gastrectomy for advanced gastric cancer, initial experience from a single institution in china
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4672481/
https://www.ncbi.nlm.nih.gov/pubmed/26643472
http://dx.doi.org/10.1186/s12957-015-0744-x
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