Utility of the Omentum in Pelvic Floor Reconstruction Following Resection of Anorectal Malignancy

• DOI: 10.1097/sap.0b013e3181ce3947
• Publication Date: 2010-04-14T07:09:02Z
• Authors: Charles S. Hultman; Matthew A. Sherrill; Eric G. Halvorson; Clara N. Lee; John F. Boggess; Michael O. Meyers; Benjamin A. Calvo; Hong J. Kim
• Keywords: Greater omentum; Pelvic exenteration; Abdominoperineal resection

This study assesses the usefulness of omentum in reconstruction complex perineal defects, following abdominoperineal resection or pelvic exenteration, for anorectal malignancy. Between 2000 and 2008, 70 patients (mean age: 59 years) with malignancy underwent (n = 57) exenteration 13) were reconstructed by primary repair alone 13), 16), myocutaneous flap 28), 13). Patients without omental flaps compared Student t test chi2 analysis. Omental based on a single pedicle, tunneled retrocolic plane lateral to ligament Treitz, transposed across sacrum floor. In total, 29 had floor omentum, 41 omentum. Incidence major complications (abscess, urinoma, deep vein thrombosis, dehiscence, hernia, bowel obstruction, fistula) was greater "no omentum" group (25/41 patients, 61%), "omentum" (6/29 21%) (P < 0.01). No differences observed regarding age, stage, incidence radiotherapy, blood loss, length stay, mortality. Use as flap, combination is associated decreased postoperative complications, strongly supporting use reconstruction.