International Journal of General Medicine (Oct 2023)
Safety and Efficacy of Partial Omentectomy in Laparoscopic Distal Gastrectomy for pT3-T4a Stage Gastric Cancer
Abstract
Min Song,1 Yifan Jiang,2 Yi Liu,2 Zonglin Li2 1Department of Laboratory Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, People’s Republic of China; 2Department of General Surgery (Gastrointestinal Surgery), The Affiliated Hospital of Southwest Medical University, Luzhou, People’s Republic of ChinaCorrespondence: Zonglin Li, Department of General Surgery (Gastrointestinal Surgery), The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, People’s Republic of China, Tel +8613982424099, Email [email protected]: Partial omentectomy (PO) has been gradually applied in laparoscopic gastrectomy for gastric cancer (GC); however, its efficacy remains unclear. The purpose of this study was to assess the safety and efficacy of PO in laparoscopic distal gastrectomy for pT3-T4a stage GC.Patients and Methods: From June 2019 to May 2021, 108 patients with pT3 or pT4a stage GC who underwent laparoscopic distal gastrectomy were retrospectively included and divided into the PO (n=58) and total omentectomy (TO, n=50) groups. The surgical outcomes, recurrence patterns and postoperative 2-year overall survival (OS) rates were compared between the PO and TO groups.Results: The PO group showed a shorter operation time than the TO group (183.9± 21.6 vs 197.6± 22.7 min, p=0.002). Less intraoperative blood loss (155.3± 113.0 vs 178.8± 154.4 mL, p=0.336) and intraoperative complications (5.1% vs 12.0%, p=0.298) were also observed in the PO group than in the TO group, but the difference was not significant. The numbers of retrieved lymph nodes (LNs) and metastatic LNs, postoperative hospital stays and postoperative complications in the two groups were comparable (p> 0.05). Moreover, the postoperative overall recurrence rates (25.9% vs 26.0%, p=0.987) and the 2-year OS rates (63.8% vs 65.4%, p=0.437) in the PO and TO groups were also comparable. TO was not an independent prognostic factor for GC patients (HR=0.806, p=0.443).Conclusion: In laparoscopic distal gastrectomy, PO could provide better surgical outcomes and comparable oncological outcomes compared to TO for patients with pT3-T4a stage GC, suggesting that PO may be an acceptable surgical procedure for these patients.Keywords: partial omentectomy, total omentectomy, gastric cancer, laparoscopic distal gastrectomy, surgical outcomes, oncological outcomes
