Omentoplasty for persistent perineal sinus after proctectomy for Crohn's disease.
Persistent perineal sinus is a common and serious cause of morbidity after proctectomy for Crohn's disease. Recently we have performed excision and omentoplasty on 6 patients with persistent perineal sinus. The perineal sinus was completely excised and communication was established with the pelvis. In 4 patients, the left gastroepiploic vessels were divided close to their origins and in 2 other patients the right gastroepiploic vessels were divided. The omentum was brought down to the perineum and it was lightly sutured to the perineal skin. After a median follow-up of 28 months, the perineal sinus had healed in 5 patients. In 1 patient the omentum became necrotic and infected 1 month after omentoplasty, and this patient still has a complex sinus. Although the number of patients is small, omentoplasty may be an effective procedure for the treatment of persistent perineal sinus after proctectomy for Crohn's disease.
Yamamoto
T
T
University Department of Surgery, Queen Elizabeth Hospital, Edgbaston, B15 2TH, Birmingham, United Kingdom. takay@clin.medic.mie-u.ac.jp
Mylonakis
E
E
Keighley
M R
MR
D000328:Adult; D003082:Colectomy; D003424:Crohn Disease / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D009852:Omentum / Q000601:surgery*; D011183:Postoperative Complications / Q000601:surgery*; D012003:Rectal Fistula / Q000209:etiology / Q000601:surgery*; D016896:Treatment Outcome