BURSECTOMY IN GASTRIC CANCER SURGERY: A META-ANALYSIS

Bursectomy consists of surgically removing the peritoneal lining covering the pancreas and the anterior plane of the transverse mesocolon during gastrectomy. However, there are little data to indicate whether bursectomy has a clinical benefit. The objective of this study was to study the effect of bursectomy on complications, recurrence, and overall survival of patients with gastric cancer. The publicly available literature published from January 2000 to July 2017 concerning gastrectomy with bursectomy and standard gastrectomy for gastric cancer was retrieved by searching the national and international online databases. Meta-analysis was performed after the data extraction process. Eight studies were finally included for a total of 1644 patients, of whom 644 underwent bursectomy and 1000 received standard gastrectomy without bursectomy. As shown by the meta-analysis results, there were no statistically significant differences in the presence of total post-operative complications (odds ratio [OR] = 1.06, 95% confidence interval [CI] [0.83-1.35], p = 0.63), overall recurrence (OR = 1.07, 95% CI [0.77-1.50], p = 0.68), 3-year overall survival (OR = 1.30, 95% CI [0.82-2.07], p = 0.26), and 5-year overall survival (OR = 0.91, 95% CI [0.66-1.27], p = 0.58). Although application of bursectomy in radical gastrectomy did not increase post-operative complications, it offered no benefit to control tumor recurrence or improve overall survival.