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Kim, Kang, Oh, Yook, Kim, and Park: Following of the Omentum Preserving Gastrectomy for Advanced Gastric Cancer without Serosa Exposure
Original Article
Journal of the Korean Surgical Society

Journal of the Korean Surgical Society 2009; 76(3): 154-158.

Published online: 31 March 2009

DOI: https://doi.org/10.4174/jkss.2009.76.3.154

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

Ji Hoon Kim, M.D., Sung Hwa Kang, M.D.1, Sung Tae Oh, M.D.1, Jung Hwan Yook, M.D.1, Byung Sik Kim, M.D.1, Kun Choon Park, M.D.1

Department of Surgery, College of Medicine, University of Ulsan, Gangneung Asan Hospital, Gangneung, Korea.

1Asan Medical Center, Seoul, Korea.

stoh@amc.seoul.kr

Received 7 November 2008       Accepted 11 December 2008

Copyright © 2009 The Korean Surgical Society

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.

Keywords: Omentum preserving gastrectomy, Omentectomy, Advanced gastric cancer

Figures and Tables

Fig. 1
Survival distributions of Omentum-preserving gastrectomy and gastrectomy with omentectomy.
jkss-76-154-g001
Table 1
Clinicopathologic characteristics of the patients
jkss-76-154-i001
Table 2
The recurrence pattern of gastric cancer after surgery
jkss-76-154-i002

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