title: [Resection of pancreatic capsule and anterior layer of transverse mesocolon in radical gastrectomy and its clinical significance].
abstract: OBJECTIVE
  To investigate the clinical significance of resection of the pancreatic capsule and anterior layer of transverse mesocolon in radical gastrectomy.
  
  
  METHODS
  Between January 2007 and July 2008, a total of 213 gastric cancer patients enrolled in the study. These patients were randomly assigned into two groups: 105 in group R and 108 in group N. Only in group R were the pancreatic capsule and anterior layer of transverse mesocolon resected during radical gastrectomy. The pancreatic capsule and anterior layer of transverse mesocolon were histologically analyzed for metastasis. The data including blood loss during operations, number of dissected lymph nodes and postoperative complications were analyzed in both groups.
  
  
  RESULTS
  There were no significant differences between the two groups in blood loss during operation and postoperative complications, but the differences in operation time and number of dissected lymph nodes between the two groups were significant. Metastases to the pancreatic capsule and/or anterior layer of transverse mesocolon were diagnosed in nine (8.6%) patients of group R. The metastases to the pancreatic capsule and/or anterior layer of transverse mesocolon were found to be associated with tumor invasion depth, anterior or posterior gastric wall, clinical staging and perigastric lymph node metastasis extent (P<0.05), but not with age, gender, tumor location, size, Borrmann type and pathological classification (P>0.05).
  
  
  CONCLUSIONS
  Resection of pancreatic capsule and anterior layer of transverse mesocolon in group R does not increase postoperative complications in comparison with group N. The resection is beneficial to the patients with advanced gastric cancer staging relatively late because of potential metastasis to pancreatic capsule and anterior layer of transverse mesocolon.
authors.affiliation: Department of General Surgery, Changhai Hospital, The Second Military Medical University, Shanghai, China.
authors.forename: Jian-wei
authors.initials: JW
authors.lastname: Bi
authors.forename: Cheng-hui
authors.initials: CH
authors.lastname: Du
authors.forename: Guo
authors.initials: G
authors.lastname: Wei
authors.forename: Kang-kang
authors.initials: KK
authors.lastname: Zhi
authors.forename: Ting
authors.initials: T
authors.lastname: Han
authors.forename: Guang-huan
authors.initials: GH
authors.lastname: Xu
authors.forename: Ji-de
authors.initials: JD
authors.lastname: Hua
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044684:Colon, Transverse; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D008297:Male; D008646:Mesocolon / Q000601:surgery*; D008875:Middle Aged; D010179:Pancreas / Q000601:surgery*; D013274:Stomach Neoplasms / Q000601:surgery*