[What does the omentum plug accomplish in colorectal tumor surgery? A 10-year follow-up]

In 23 of 47 patients who underwent surgery for malignant colorectal tumors between January 1978 and December 1986, the residual cavity was treated with a pedicled omental plug after radical resection of the tumor-bearing areas. There was advanced transmural tumor spread in 13 omentum patients and in 9 operated without using omentum. The other patients had equally distributed T2 and T3 stage tumors. Complications were similar in both groups, but perineal infection was slightly less frequent and less significant in the omentum group. Hospitalization was 23 days in patients with the omental plug and 34 days in the others. Life quality, as shown by the activity index, was better in the omentum group. 30-day postoperative mortality was 8.5% in both groups. Individual survival after surgery was 23 months with the omental plug, compared with 15 months in patients without this procedure. At 5 years, however, survival rate was similar. Postmortem revealed no tumor spread alongside the transposed omentum, which had changed to a mesentery-like structure. From these results it is clear that the omentum plug does not achieve cure in carcinoma or longterm survival, but improves the complication rate and individual survival time. We can therefore recommend this procedure as palliative treatment, since even extensive defects can be covered effectively by omentum.