[Abdominal complications of the pedicled omental flap in chest surgery]

The incidence of abdominal complications and the gastrointestinal function after omental pedicle wrapping (Group I: n = 13) were compared with those after right pneumonectomy (Group II: n = 9) and cholecystectomy (Group III: n = 22). Indications of the omentopexy were as follows: 1) prophylaxis for the bronchial complication after chest surgery (4 cases), 2) treatment of thoracic empyema (2 cases) and 3) postoperative bronchopleural fistula (7 cases). Poor intestinal movement necessitating fast after surgery persisted significantly longer in Group I than in Group II (p less than 0.05), but no significant difference was observed between Group I and Group III. Abdominal complications were observed frequently in Group I when oral feeding was initiated; abdominal distension in 7 of 13 cases (54%), epigastric discomfort in 3 (23%) and dehiscence of the abdominal wound in 4 (31%). Abdominal wound dehiscences were most frequently encountered after surgical treatment with the omentopexy for empyema thoracic (2/2, 100%) and for bronchopleural fistula (2/7, 28%). Upper GI examination was performed in seven cases, four of which (57%) showed the deformity of antral region of the stomach. Since this finding was not always accompanied with the symptom of gastric retention, it was likely that gastric retention following the omentopexy was caused by dissection of right gastroepiploic nerves rather than the anatomical deformity of the stomach.