Omental transposition to mediastinum improves the outcome of postoperative intra-thoracic infections of Ivor-Lewis surgery

Abstract

To study the efficacy of pedicled greater omentum transposed to mediastinum in prevention against postoperative in-hospital intrathoracic complications after esophagectomy. Clinical data of 148 consecutive patients with esophageal cancer undergoing Ivor-Lewis surgery in our department from January 2010 to May 2014 were retrospectively reviewed. Among them, 84 patients with omental transposition(transposition group) and 64 patients without omental transposition(non-transposition group) were compared. Postoperative hospital stay was shorter in patients with omental transposition compared to those without omental transposition(P<0.05). Intrathoracic infection rate was significantly lower in transposition group(33/84, 39.3%) than that in non-transposition group(36/64, 56.2%), and as was the combined sepsis rate[19/33, 57.6% vs. 31/36, 86.1%, P<0.05]. No significant differences were found in the morbidity of anastomotic leakage, wound infection, cardiac complication and mortality during hospitalization. The median postoperative hospital stay was significantly shorter in transposition group than that in non-transposition group(13.0 vs. 16.5 days, P<0.05). Omental transposition to mediastinum can reduce the development and severity of intrathoracic infection and shorten hospital stay in patients undergoing esophagectomy.