The efficacy of non-complete omentectomy in the radical gastrectomy for gastric cancer: a meta-analysis and systematic review.

IF 2.1 3区医学 Q2 SURGERY

Langenbeck's Archives of Surgery Pub Date : 2025-06-03 DOI:10.1007/s00423-025-03760-2

Chenglong Gao, Wenchao Shi, Baoming Zhang, Qiang Tang, Huiyu Chen, Zengtao Bao

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Abstract

Background: Surgery is considered a necessary treatment for gastric cancer (GC), but the extent of resection remains controversial. This study aimed to evaluate the efficacy of non-complete omentectomy (NCO) in GC patients undergoing radical gastrectomy.

Methods: We searched for studies of non-complete omentectomy versus complete omentectomy (CO) published before February 2024 from PubMed, Web of Science, and Cochrane Library databases. From the extracted clinical data, we compared surgical, survival, and recurrence outcomes between the two groups.

Results: Thirteen studies with a total of 4255 patients were included. The meta-analysis showed that compared with the CO group, the NCO group was associated with a lower overall recurrence rate, shorter operative time, and fewer postoperative complications. However, there was no significant difference in the number of harvested lymph nodes and peritoneal recurrence rate between the two groups. The NCO group was associated with the higher 3-year overall survival (OS) rate (RR = 0.95, 95% CI = 0.91-0.99, P = 0.02), 5-year OS rate (RR = 0.91, 95% CI = 0.87-0.96, P = 0.0006), and 5-year relapse-free survival (RFS) rate (RR = 0.93, 95% CI = 0.87-0.99, P = 0.02). However, it was not associated with the 3-year RFS rate (RR = 0.95, 95% CI = 0.89-1.01, P = 0.12) compared with the CO group.

Conclusion: Regarding surgical, survival, and recurrence outcomes, performing NCO versus CO during radical gastrectomy provides no significant advantage. However, future high-quality and well-designed randomized controlled trials are necessary to validate the results.

查看原文本刊更多论文

不完全网膜切除术在胃癌根治术中的疗效：荟萃分析和系统评价。

背景：手术被认为是胃癌（GC）的必要治疗方法，但切除的范围仍有争议。本研究旨在评估不完全网膜切除术（NCO）在胃癌根治性胃切除术患者中的疗效。方法：我们从PubMed、Web of Science和Cochrane Library数据库中检索2024年2月之前发表的关于非完全网膜切除术与完全网膜切除术（CO）的研究。从提取的临床资料中，我们比较了两组之间的手术、生存和复发结果。结果：13项研究共纳入4255例患者。meta分析显示，与CO组相比，NCO组总复发率更低，手术时间更短，术后并发症更少。然而，两组在淋巴结清扫数量和腹膜复发率上无显著差异。NCO组3年总生存率（OS）（RR = 0.95, 95% CI = 0.91-0.99, P = 0.02）、5年OS （RR = 0.91, 95% CI = 0.87-0.96, P = 0.0006）、5年无复发生存率（RFS）（RR = 0.93, 95% CI = 0.87-0.99, P = 0.02）较高。但与CO组相比，与3年RFS率无相关性（RR = 0.95, 95% CI = 0.89-1.01, P = 0.12）。结论：就手术、生存和复发结果而言，在根治性胃切除术中，NCO与CO没有明显的优势。然而，未来需要高质量和精心设计的随机对照试验来验证结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Langenbeck's Archives of Surgery 医学-外科

CiteScore

3.30

自引率

8.70%

发文量

342

审稿时长

4-8 weeks

期刊介绍： Langenbeck''s Archives of Surgery aims to publish the best results in the field of clinical surgery and basic surgical research. The main focus is on providing the highest level of clinical research and clinically relevant basic research. The journal, published exclusively in English, will provide an international discussion forum for the controlled results of clinical surgery. The majority of published contributions will be original articles reporting on clinical data from general and visceral surgery, while endocrine surgery will also be covered. Papers on basic surgical principles from the fields of traumatology, vascular and thoracic surgery are also welcome. Evidence-based medicine is an important criterion for the acceptance of papers.