Sutured Perineal Omentoplasty After Abdominoperineal Resection for Adenocarcinoma of the Lower Rectum

Abstract

This study demonstrated that sutured perineal omentoplasty is possible in the majority of patients after abdominoperineal resection for adenocarcinoma of the lower rectum with excellent primary perineal wound healing.

Factors affecting the healing of the perineum following surgery

“…27 Sutured omentoplasty was reported to have a 100% wound healing rate at three months. 28 Our findings that examination under anaesthesia was associated with poor healing may be a reflection of preference of the surgeon to select those with high risk wounds.…”

Omentoplasty in Abdominoperineal Resection: A Review of the Literature Using a Systematic Approach

“…36 In four publications, data were collected prospectively, 30,33,36,40 and six were retrospective studies. 23,28,[37][38][39]43 Patients reported in one publication 33 also may have been reported in another. 36 The studies included are summarized in Table 2.…”

“…13,15,23,[28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43] Seven publications were excluded because fewer than ten patients were included. 13,15,29,32,34,41,42 In addition, outcomes for patients in whom an omentoplasty was performed were not specified in two reports, and they were excluded.…”

Pelvic reconstruction after abdominoperineal resection: a pilot study using an absorbable synthetic prosthesis

“…An omental pedicle flap based on the left gastroepiploic vessels is left free or sutured into place in the pelvis. Alternatively, an omentopexy is performed using the omentum as a ''hammock,'' suturing the omental free edges to the sacral promontory, anterior abdominal wall and colon serosa [13][14][15][16][17][18][19][20][21][22][23][24][25]. Despite the extensive use of autologous tissues, especially the greater omentum, for creating a pelvic partition, there is no solid scientific evidence to support the use of one method over another.…”