Despite the advancement of technology and neoadjuvant/adjuvant chemotherapy,molecular targeted agents,gastrectomy,and D2 lymph node dissection are the only curative treatment option for advanced gastric cancer(GC).The...Despite the advancement of technology and neoadjuvant/adjuvant chemotherapy,molecular targeted agents,gastrectomy,and D2 lymph node dissection are the only curative treatment option for advanced gastric cancer(GC).The most common sites of recurrence in patients with GC are the peritoneum and omentum.The omentum contains areas rich in lymphatic tissue(the milky area)that form the connection between the peritoneum and the lymphatic system.Tumor cells are often found in these areas.Therefore,omentectomy is added to radical gastric resection and modified D2 lymph node dissection in the treatment of GC.Total omentectomy is recommended by Western countries for GC diagnosed at T3-4 stage,while Japanese research suggests partial omentectomy at T1-2 stage and total omentectomy at T3-4 stage due to early diagnosis of GC.In addition to the differences in tumor biology,the fact that patients in Western countries are more likely to receive perioperative chemotherapy and the 5%incidence of omental metastasis in advanced disease has led to the belief that partial omentectomy is an adequate surgical procedure compared with total omentectomy.There are studies recommending total omentectomy for the removal of possible tumor foci,and there are some studies reporting that partial omentectomy is sufficient even in advanced GC.The aim of this review was to investigate whether total or partial omentectomy should be performed in patients with GC.展开更多
BACKGROUND The omentum is an organ that is easily sacrificed during abdominal surgery.The scope of omentectomy and whether a routine omentectomy should be performed are still unknown.AIM To review the literature in or...BACKGROUND The omentum is an organ that is easily sacrificed during abdominal surgery.The scope of omentectomy and whether a routine omentectomy should be performed are still unknown.AIM To review the literature in order to determine the physiological functions of the omentum and the roles it plays in pathological events in order to reveal the necessity for removal and preservation of the omentum.METHODS A clinical review of the English language literature based on the MEDLINE(PubMed)database was conducted using the keywords:“abdomen”,“gastrointestinal”,“tumor”,“inflammation”,“omental flap”,“metastasis”,“omentum”,and“omentectomy”.In addition,reports were also identified by systematically reviewing all references in retrieved papers.RESULTS The omentum functions as a natural barrier in areas where pathological processes occur in the abdominal cavity.The omentum limits and controls inflammatory and infectious pathologies that occur in the abdomen.It also aids in treatment due to its cellular functions including lymphatic drainage and phagocytosis.It shows similar behavior in tumors,but it cannot cope with increasing tumor burden.The stage of the disease changes due to the tumor mass it tries to control.Therefore,it is considered an indicator of poor prognosis.Due to this feature,the omentum is one of the first organs to be sacrificed during surgical procedures.However,there are many unknowns regarding the role and efficacy of the omentum in cancer.CONCLUSION The omentum is a unique organ that limits and controls inflammatory processes,foreign masses,and lesions that develop in the abdominal cavity.Omental flaps can be used in all anatomical areas,including the thorax,abdomen,pelvis,and extremities.The omentum is an organ that deserves the title of the abdominal policeman.It is generally accepted that the omentum should be removed in cases where there is tumor invasion.However,the positive or negative contribution of omental resection in the treatment of abdominal pathologies should be questioned.展开更多
INTRODUCTIONThe word omentum derives from the ancientEgyptians who,when embalming human bodies,used to assess their'omens'by looking at thevariations in what we recognise today as theomentum.Galen(128-199 AD)t...INTRODUCTIONThe word omentum derives from the ancientEgyptians who,when embalming human bodies,used to assess their'omens'by looking at thevariations in what we recognise today as theomentum.Galen(128-199 AD)thought that therole of the omentum was to warm the intestines.This was on the basis of a gladiator who had anomental resection after a stab injury and sufferedgreatly from cold for the rest of his life.A展开更多
文摘Despite the advancement of technology and neoadjuvant/adjuvant chemotherapy,molecular targeted agents,gastrectomy,and D2 lymph node dissection are the only curative treatment option for advanced gastric cancer(GC).The most common sites of recurrence in patients with GC are the peritoneum and omentum.The omentum contains areas rich in lymphatic tissue(the milky area)that form the connection between the peritoneum and the lymphatic system.Tumor cells are often found in these areas.Therefore,omentectomy is added to radical gastric resection and modified D2 lymph node dissection in the treatment of GC.Total omentectomy is recommended by Western countries for GC diagnosed at T3-4 stage,while Japanese research suggests partial omentectomy at T1-2 stage and total omentectomy at T3-4 stage due to early diagnosis of GC.In addition to the differences in tumor biology,the fact that patients in Western countries are more likely to receive perioperative chemotherapy and the 5%incidence of omental metastasis in advanced disease has led to the belief that partial omentectomy is an adequate surgical procedure compared with total omentectomy.There are studies recommending total omentectomy for the removal of possible tumor foci,and there are some studies reporting that partial omentectomy is sufficient even in advanced GC.The aim of this review was to investigate whether total or partial omentectomy should be performed in patients with GC.
文摘BACKGROUND The omentum is an organ that is easily sacrificed during abdominal surgery.The scope of omentectomy and whether a routine omentectomy should be performed are still unknown.AIM To review the literature in order to determine the physiological functions of the omentum and the roles it plays in pathological events in order to reveal the necessity for removal and preservation of the omentum.METHODS A clinical review of the English language literature based on the MEDLINE(PubMed)database was conducted using the keywords:“abdomen”,“gastrointestinal”,“tumor”,“inflammation”,“omental flap”,“metastasis”,“omentum”,and“omentectomy”.In addition,reports were also identified by systematically reviewing all references in retrieved papers.RESULTS The omentum functions as a natural barrier in areas where pathological processes occur in the abdominal cavity.The omentum limits and controls inflammatory and infectious pathologies that occur in the abdomen.It also aids in treatment due to its cellular functions including lymphatic drainage and phagocytosis.It shows similar behavior in tumors,but it cannot cope with increasing tumor burden.The stage of the disease changes due to the tumor mass it tries to control.Therefore,it is considered an indicator of poor prognosis.Due to this feature,the omentum is one of the first organs to be sacrificed during surgical procedures.However,there are many unknowns regarding the role and efficacy of the omentum in cancer.CONCLUSION The omentum is a unique organ that limits and controls inflammatory processes,foreign masses,and lesions that develop in the abdominal cavity.Omental flaps can be used in all anatomical areas,including the thorax,abdomen,pelvis,and extremities.The omentum is an organ that deserves the title of the abdominal policeman.It is generally accepted that the omentum should be removed in cases where there is tumor invasion.However,the positive or negative contribution of omental resection in the treatment of abdominal pathologies should be questioned.
文摘INTRODUCTIONThe word omentum derives from the ancientEgyptians who,when embalming human bodies,used to assess their'omens'by looking at thevariations in what we recognise today as theomentum.Galen(128-199 AD)thought that therole of the omentum was to warm the intestines.This was on the basis of a gladiator who had anomental resection after a stab injury and sufferedgreatly from cold for the rest of his life.A
