Omental packing with continuous suction drainage following abdominoperineal resection

Primary closure of the perineum along with drainage after abdominoperineal resection for lower rectal cancer is a widely accepted procedure but is associated with non-healing of the perineal wound a major complication. We evaluated the efficacy of omental packing and continuous suction drainage after abdominoperineal resection.

We retrospectively studied 45 patients with adenocarcinoma of the lower rectum who underwent abdominoperineal resection, either without omental packing (NOP group) or with omental packing and continuous suction drainage (OPCD group). A pedicled omentum supplied by the epiploic arcade was conducted and drawn down through the perineal wound, over the small intestine and into the pelvis. Drains were placed on both sides of the pelvis through the perineal wall and continuous suction was performed.

Perineal wound infection was significantly more frequent in the NOP group (32%) than in the OPCD group (5%). Ileus was not observed in the OPCD group. The duration of hospitalization was shorter in the OPCD group (17.8±4.2 days) than in the NOP group (21.0±9.1 days).

Omental packing with continuous suction is useful to prevent non-healing of the perineal wound after abdominoperineal resection for lower rectal cancer.