Background: Resection of the omental bursa has been suggested to reduce peritoneal recurrence and facilitate a complete oncological resection during a gastrectomy. The addition of this procedure increases technical complexity and prolongs the procedure. Published data regarding the oncological benefit of this procedure are conflicting. We hypothesized that a bursectomy during a radical gastrectomy does not improve overall survival. Methods: In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guideline, a comprehensive literature search of 3 electronic databases (PubMed, Scopus, and Embase) was conducted to identify the clinical studies that compared bursectomy with no-bursectomy in radical gastrectomy for gastric adenocarcinoma. Qualitative and quantitative data synthesis was performed using RevMan software. A random-/fixed-effect modeling was used depending upon the heterogeneity. Bias and quality assessment tools were applied. The study was registered with the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42019116556). Results: Of 8 studies assessing the role of bursectomy in gastric adenocarcinoma, 6 (75%) were included – of which 2 (33%) are randomized controlled trials. Of 2,904 patients, 1,273 (%) underwent a bursectomy. There was no statistically significant difference in either overall survival (hazard ratio [HR] = 0.89, 95% CI 0.75–1.06, I² = 14%) or disease recurrence (HR = 1.01, 95% CI 0.84–1.20, I² = 22%) in the bursectomy group compared to the no-bursectomy group. Conclusion: There is no additional oncological benefit of adding bursectomy to radical gastrectomy in all patients with gastric adenocarcinoma.
Visc Med

中文翻译：

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根治性胃切除术中粘液囊切除术缺乏肿瘤学益处：系统评价

背景：已建议切除网膜囊以减少腹膜复发并促进胃切除术中的完全肿瘤切除。添加此程序会增加技术复杂性并延长程序。关于该程序的肿瘤学益处的已发表数据是相互矛盾的。我们假设在根治性胃切除术中进行滑囊切除术不会提高总体生存率。方法：根据系统评价和荟萃分析 (PRISMA) 报告指南的首选报告项目，对 3 个电子数据库（PubMed、Scopus 和 Embase）进行了全面的文献检索，以确定比较滑囊切除术和非滑囊切除术的临床研究在胃腺癌的根治性胃切除术中。使用 RevMan 软件进行定性和定量数据合成。根据异质性使用随机/固定效应模型。应用了偏差和质量评估工具。该研究已在国际前瞻性系统评价登记册 (PROSPERO) 中注册 (CRD42019116556)。结果：在评估囊切除术在胃腺癌中的作用的 8 项研究中，包括 6 项 (75%)，其中 2 项 (33%) 是随机对照试验。在 2,904 名患者中，1,273 (%) 名接受了滑囊切除术。总生存率（风险比 [HR] = 0.89，95% CI 0.75–1.06， I ² = 14%）或疾病复发（HR = 1.01，95% CI 0.84–1.20，I ² = 22%）在滑囊切除术组与非滑囊切除术组相比。结论：在所有胃腺癌患者中，在根治性胃切除术的基础上增加法氏囊切除术没有额外的肿瘤学益处。
维斯克医学