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Published on: October 25, 2024
Omental pedicle flaps following proctectomy: a systematic review
Summary
Omental pedicle grafts following abdominoperineal excision (APR) significantly improve perineal wound healing. This technique reduces complications and speeds recovery with minimal impact on operating time.
Area of Science:
- Surgical Oncology
- Gastrointestinal Surgery
- Wound Healing Research
Background:
- Abdominoperineal excision (APR) for anorectal cancer is associated with substantial perineal wound morbidity.
- Omentoplasty, using an omental pedicle graft, is a reconstructive technique employed to mitigate these complications after radical surgery.
Purpose of the Study:
- To evaluate the efficacy of omentoplasty in reducing perineal wound complications after abdominoperineal excision (APR).
Main Methods:
- A systematic literature review was conducted across PubMed, MEDLINE, and the Cochrane Library.
- Included studies reported outcomes of APR with and without omentoplasty from 1950 to 2012.
Main Results:
- Fourteen studies with 891 patients were analyzed. Omentoplasty was associated with a higher primary wound healing rate (66.8% vs. 50.1%) and faster healing time (24 days vs. 79 days).
- The weighted mean wound infection rate was lower with omentoplasty (14.4% vs. 18.5%).
- Omentoplasty added a median of 20 minutes to operative time with minimal flap-associated morbidity.
Conclusions:
- Omentoplasty following abdominoperineal excision effectively reduces perineal wound morbidity.
- The technique offers significant benefits in wound healing and complication rates with a negligible increase in surgical time.
