Omentoplasty for pelvic defect closure following abdominoperineal resection in lower rectum cancer

Abstract

BackgroundThe perineal wound is considered an important source of postoperative morbidity and mortality following abdominoperineal resection (APR). Complications include wound dehiscence, infection, abscess, perineal herniation, radiation enteritis, persistent sinus, more nursing effort, prolonged hospital stay, and increase readmission with cost increase.AimThe aim of this study is to compare the result of conventional closure of pelvic defect following APR versus closure with omentoplasty.Patients and methodsThis study included 30 patients who underwent APR. The patients were divided into two groups: omentoplasty group included 15 patients who underwent pelvic defect closure using pedicle omental flap, and conventional group included 15 patients who underwent surgery with conventional closure of pelvic defect.TechniqueVoluminous omental flap is harvested with proper length, with good perfusion and vascularity. Then, it is used as plug for closure of the dead space in the pelvis obtained after APR.ResultsPedicle omental flap fashioning, mobilization, and transposition supporting perineal defect following APR results in reduction of pelvic dead space and enables safe closure with reasonable operative time and reduction in postoperative wound complications.ConclusionOmentoplasty for closure of pelvic defect following APR is an applicable and safe method that supports perineal wound closure with less complications.