| Objective: Clinical data of gastric cancer patients treated with radical gastrectomy in our hospital was retrospectively analyzed,and the effect of retaining the greater omentum in the radical gastrectomy was evaluated and studied.Materials and Methods:1.Patient Population The retrospective analysis collected data from 1120 patients with gastric cancer diagnosed as T≤T3 during surgery in our hospital from January2010 to Aug ust 2015.All 1120 patients’ surgical records were retrieved,and they were all treated with radical gastrectomy.The post-operation clinical data were collected via telephone or in-person interviews.996 patients with complete medical records and follow up data were selected for the study.2.Patient Categorization.Based on surgical records and follow-up interviews findings,patients were divided into omentum-preserving group(744 subjects)and omentum-removing group(252 subjects).3.Results and Evaluation Operation time,hospital sty,incidence of complications,recurrence rate,3-year survival rate and 5-year survival rates of the two groups were compared and analyzed by SPSS 22.0 statistical software.Other statistical methods include chi-square test,single factor analysis by Kapalan-merie method(log-rank test)and multiple factor analysis by Cox regression analysis.Statistical significant results are represented by a P-value less than 0.05.Results: According to the Post-operation pathological data of 996 patients,there were330 tumors(33.1%)in T1 stage,105 tumors(10.5%)in T2 stage,405 tumors(40.7%)in T3 stage and 156 tumors(15.7%)in T4 a stage.By comparing the survival rates of the two groups,we found that the three-year and five-year survival rates of the omentum-removing group and the omentum-preserving group were 84.5% and 77.4%,81.0% and 73.0% respectively(P>0.05).There was no significant difference in the 3and 5-year survival rate between the two groups.There was no significant difference in laparoscopic surgery or not between the two groups(P< 0.05).In addition,we found that there was no significant difference in the incidence of total complications between the omentum-preserving group and the omentum-removing group(12.2%,12.3%,P<0.05).Moreoever,13 patients(1.6%)had intestinal obstruction in the omentum-preserving group,while 21 patients(8.3%)had intestinal obstruction in the Omentum-removing group.The incidence of intestinal obstruction in the reserving group was lower than that in the resection group(P<0.05).We found no significant difference in the incidence of postoperative bleeding,anastomotic fistula,acute pancreatitis and other complications between the two groups(P>0.05).Due to the incomplete data of some patients about pancreatic fistula after operation,311 cases with relatively complete data were selected and analyzed separately(the omentum-preserving group 238 cases,the omentum-removing group 73 cases).The incidence of pancreatic fistula in the two groups was 21% and 31.5%(P< 0.05).Statistical analysis showed that there was no statistical significance between the two groups,but it could be seen that the incidence of the omentum-preserving group was lower than that of the omentum-removing group.However,the operation time of the omentum-preserving group was relatively shorter,and the average operation time of the omentum-preserving group and the omentum-removing group were(3.21±1.30,3.95±1.39,P<0.05)respectively.The post-operation hospital stay time of theomentum-preserving group(7.91±6.52d)was shorter than that of the omentum-removing group(9.05±9.60d)(P<0.05).We also found no statistical significant difference in the probability of recurrence of gastric stump cancer between the two groups(P=0.52).At the same time,there was no significant difference in whether chemotherapy,age and sex between the two groups(P>0.05).Conclusions: Reserving omentum in radical gastrectomy for gastric cancer patients with tumor invasion depth T≤T3 can achieve the same clinical effect as traditional radical gastrectomy for gastric cancer with omentum resection,but it does not significantly impact the survival rate of patients after operation.It can effectively reduce the incidence of intestinal obstruction,reduce operation time and hospital stay without any negative impact on long-term outcomes.For the analysis of pancreatic fistula after operation,a large sample of prospective studies are needed to support the analysis. |
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