Snapshot Study on the Value of Omentoplasty in Abdominoperineal Resection with Primary Perineal Closure for Rectal Cancer

Autor: Pieter Tanis, Anne Marthe Schreuder, Jurriaan Tuynman, David Zimmerman, Paul Verheijen, David Brinkman, Robin Blok, Michel Wouters, Boudewijn Toorenvliet
Přispěvatelé: ​Robotics and image-guided minimally-invasive surgery (ROBOTICS), Surgery, CCA - Cancer Treatment and quality of life, AGEM - Re-generation and cancer of the digestive system, APH - Quality of Care, APH - Global Health, ACS - Microcirculation, CCA - Cancer Treatment and Quality of Life, Graduate School, Center of Experimental and Molecular Medicine, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, Other departments
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Zdroj: Annals of Surgical Oncology, 25(3), 729-736. SPRINGER
Annals of Surgical Oncology, 25, 729-736
Annals of Surgical Oncology
Blok, R D, Musters, G D, Borstlap, W A A, Buskens, C J, Bemelman, W A, Tanis, P J & Collaborative Dutch Snapshot Research Group 2018, ' Snapshot Study on the Value of Omentoplasty in Abdominoperineal Resection with Primary Perineal Closure for Rectal Cancer ', Annals of Surgical Oncology, vol. 25, no. 3, pp. 729-736 . https://doi.org/10.1245/s10434-017-6273-9
Annals of Surgical Oncology, 25, 3, pp. 729-736
Annals of Surgical Oncology, 25(3), 729-736. Springer New York
Annals of surgical oncology, 25(3), 729-736. Springer New York
ISSN: 1534-4681
1068-9265
DOI: 10.1245/s10434-017-6273-9
Popis: Background Perineal wound complications are often encountered following abdominoperineal resection (APR). Filling of the pelvic space by omentoplasty (OP) might prevent these complications, but there is scant evidence to support its routine application. Objective The aim of this study was to evaluate the impact of OP on perineal wound complications. Methods All patients undergoing APR with primary perineal closure (PPC) for non-locally advanced rectal cancer in 71 Dutch centers in 2011 were selected from a cross-sectional snapshot study. Outcomes were compared between PPC with or without OP, which was based on variability in practice among surgeons. Results Of 639 patients who underwent APR for rectal cancer, 477 had a non-locally advanced tumor and PPC was performed. Of those, 172 (36%) underwent OP. Patients with OP statistically more often underwent an extralevator approach (32% vs. 14%). Median follow-up was 41 months (interquartile range 22–47). There were no significant differences with or without OP in terms of non-healing of the perineal wound at 30 days (47% vs. 48%), non-healing at the end of follow-up (9% vs. 5%), pelvic abscess (12% vs. 13%) or re-intervention for ileus (5% vs. 3%). Perineal hernia developed significantly more often after OP (13% vs. 7%), also by multivariable analysis (odds ratio 2.61, 95% confidence interval 1.271–5.364; p = 0.009). Conclusions In contrast to previous assumptions, OP after APR with PPC appeared not to improve perineal wound healing and seemed to increase the occurrence of perineal hernia. These findings question the routine use of OP for primary filling of the pelvic space. Electronic supplementary material The online version of this article (10.1245/s10434-017-6273-9) contains supplementary material, which is available to authorized users.
Databáze: OpenAIRE
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