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    Early-stage outcomes of bursectomy in surgery of gastric cancer and radical gastric resection
    (2019) Cikot, Murat; Binboga, Sinan; Gemici, Eyup; Surek, Ahmet; Kones, Osman; Alis, Halil
    Aim: Bursectomy, mainly defined as a complete dissection of the peritoneal lining covering the anterior plane of the transverse mesocolon and the pancreas with an omentectomy during gastrectomy, has been performed for the serosa-positive gastric cancers. Recently, some researchers have interrogated whether bursectomy for gastric cancer is essential from a surgical point of view, thus, we aimed to investigate the short-term surgical and early-stage clinicopathological outcomes of bursectomy in the treatment of advanced gastric cancer patients by a single center study and retrospective controlled trial. Material and Methods: From January 2016 to December 2017, retrospective findings of selected 100 gastric cancer patients in advanced tumor stages and underwent D2 radical gastrectomy were grouped and analyzed in terms of bursectomy performed or not in Bakirkoy Dr. Sadi Konuk Training and Research Hospital. Results: In conclusion, 50 patients were in bursectomy (B) group and 50 patients in non-bursectomy (NB) group. Clinical features (age, gender, and gastrectomy pattern and tumor location) of both groups showed no statistically significant difference. Postoperative mortality rate were also similar of both groups (4%). All other post-operative complications were not significantly distinctive for two groups. Conclusions: Bursectomy may increase the surgical duration of D2 gastrectomy and but not early-stage outcomes and postoperative complications. Experienced surgeons can perform the procedure safely. However, long-term, large sample sized, and high-quality randomized controlled trials are needed for the survival benefits of bursectomy.
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    Enhanced recovery after surgery (ERAS) protocol in gastric cancer: Early term results
    (2018) Cikot, Murat; Gemici, Eyup; Kones, Osman; Akarsu, Cevher; Alis, H.
    Aim: To evaluate the effects of enhanced recovery after surgery (ERAS) protocol on morbidity and mortality in patients undergoing surgery due to gastric cancer. Material and Methods: Data of a total of 40 patients who were operated due to gastric cancer with ERAS between May 2016 and December 2016 were retrospectively analyzed. Morbidity and mortality results were evaluated as local or systemic depending on whether they developed within postoperative 30 days and whether they developed due to operation. The American Society of Anesthesiologists (ASA) classification was used to assess preoperative risk. Surgical complications were classified according to the Clavien-Dindo classification and pathological staging was performed according to the Tumor, Node, Metastasis (TNM) classification. Results: Four patients were in ASA I, 11 patients were in ASA II, 24 patients were in ASA III, and one patient was in ASA IV. The mean duration of surgery was 165 (range: 150 to 210) min in total gastrectomy and 115 (range: 95 to 140) min in subtotal gastrectomy. According to the TNM classification, four patients had Stage I, 10 patients had Stage II, and 26 patients had Stage III disease. The mean duration of hospitalization was nine (range: 6 to 21) days in total gastrectomy and six (range: 4 to 15) days in subtotal gastrectomy. The number of morbidities was 15% with a 2.5% mortality rate. Conclusion: Our study results suggest that ERAS protocol is an evidence-based quality protocol which can be reliably applied even in advanced stage gastric cancer with a high ASA score.