Influence of bursectomy on operative morbidity and mortality after radical gastrectomy for XXXX : results of a randomized controlled trial.

@entity1 @entity455 @entity834 @entity548 @entity55 @entity190 @entity6177 @entity260 @entity3472 @entity1744 @entity356
BACKGROUND: Bursectomy, a procedure dissecting the peritoneal lining covering the pancreas and the anterior plane of the transverse mesocolon, has been commonly performed with radical gastrectomy for @entity356 @entity1 . Although possibly improving the prognosis of @entity356 , adverse events related to bursectomy should be evaluated in prospective studies. METHODS: This prospective randomized controlled trial was conducted by experienced surgeons in 11 Japanese institutions. @entity1 with T2 or T3 @entity356 were intraoperatively randomized to radical gastrectomy plus D2 lymphadenectomy either with or without bursectomy. Postoperative morbidity and mortality were compared between the two groups. RESULTS: A total of 210 @entity1 were assigned to the bursectomy group (104 @entity1 ) and the nonbursectomy group (106 @entity1 ) between July 2002 and January 2007. Background characteristics were well balanced. Intraoperative @entity190 was greater in the bursectomy group than in the nonbursectomy group (median 475 vs. 350 ml, p = 0.047), whereas other surgical factors did not vary significantly. The overall morbidity rate was 14.3% (30 @entity1 ), the same for the two groups. Likewise, the incidence of @entity260 , including @entity3472 , @entity834 , @entity6177 , @entity1744 , @entity548 , and @entity55 , were not significantly different between the two groups. The medians of the amylase level of the drainage fluid on postoperative day 1 were similar for the two groups (median 282 vs. 314 IU/L, p = 0.543). The hospital mortality rate was 0.95%: one @entity1 per group. CONCLUSIONS: Experienced surgeons could safely perform a D2 gastrectomy with an additional bursectomy without @entity455 .
