Omentoplasty versus no omentoplasty for cervical esophagogastrostomy following radical esophagectomy.
OBJECTIVE
Omentoplasty--wrapping the omentum around the alimentary tract anastomosis is thought to lower the rate of anastomotic leakage. We evaluated the role of omentoplasty to reinforce cervical esophagogastrostomy after radical esophagectomy.


METHODS
We compared anastomotic leakage, stricture formation, and related deaths in 63 patients who underwent radical esophagectomy and cervical esophagogastrostomy, with (n = 48) or without (n = 15) omentoplasty, between 1995 and 1999.


RESULTS
An esophageal anastomotic leakage was diagnosed in 1 of the 48 patients (2.1%) with omentoplasty versus 3 of the 15 patients (20.0%) without omentoplasty (P < 0.01). Anastomotic stricture occurred in 2 (4.2%) of the omentoplasty group and 1 (6.7%) of the no omentoplasty group (P < 0.01). Death within 1 month was zero in the omentoplasty group and one (6.7%) in the no-omentoplasty group, despite no differences in lethal anastomotic leakage.


CONCLUSIONS
Omentoplasty of cervical esophagogastrostomy reduced anastomotic leakage. Although promising, these observations require confirmation with a randomized prospective study.
Ohwada
Susumu
S
Second Department of Surgery, Gunma University Faculty of Medicine, 3-39-15 Showa-Machi, Maebashi 371-8511, Japan. sohwada@med.gunma-u.ac.jp
Ogawa
Tetsushi
T
Kawate
Susumu
S
Koyama
Toru
T
Yamada
Tatsuya
T
Yoshimura
Sumihiko
S
Sato
Yoshihiro
Y
Tomizawa
Naoki
N
Ohya
Toshihiro
T
Morishita
Yasuo
Y
D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods*; D003131:Combined Modality Therapy; D013505:Digestive System Surgical Procedures / Q000379:methods*; D004938:Esophageal Neoplasms / Q000601:surgery*; D016629:Esophagectomy / Q000379:methods*; D005260:Female; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods; D008297:Male; D008875:Middle Aged; D009852:Omentum / Q000637:transplantation*; D016896:Treatment Outcome