[Omentoplasty is effective in lowering the complications of ano-rectal resections].
OBJECTIVE
The aim of this prospective, randomized study was to investigate the influence of omentoplasty on complications following colorectal resection, Hartmann's intervention and abdominoperineal amputation.


METHODS
One hundred and seventy-one patients undergoing elective or emergency surgery for malignancy, benign tumor, diverticular disease and others were randomly assigned to omentoplasty (OP group) or not (NO group). The primary goal was to evaluate the rate of clinical and radiological anastomotic leakage. The secondary goal was to assess the morbidity (mainly septic complications) following Hartmann's and Miles' procedures.


RESULTS
In colorectal anastomosis, 18 patients (14.3%) had anastomotic leakage, 4 (6.4%) in the OP group and 14 (21.9%) in the NO group. Differences between the 2 groups were also found in terms of repeat operations (3.2% vs 14.1%) and deaths (3.2% vs 7.8%). Other factors associated with anastomotic leakage were the distal site of anastomosis (<5 cm from anal verge) and the emergency. In Hartmann's and Miles' procedures, septic complications were reduced in the OP group.


CONCLUSIONS
Omental wrap, with its mechanical and biological properties, seems to be effective in lowering the rate and the severity of complications after colorectal and anal surgery.
Dipartimento di Scienze Chirurgiche, Università degli Studi di L'Aquila, L'Aquila, Italy. alagni@tin.it
A
A
Agnifili
M
M
Schietroma
A
A
Carloni
S
S
Mattucci
G
G
Caterino
F
F
Carlei
D000005:Abdomen / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001003:Anal Canal / Q000601:surgery*; D000714:Anastomosis, Surgical; D003106:Colon / Q000601:surgery*; D003125:Colostomy; D003627:Data Interpretation, Statistical; D004630:Emergencies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009852:Omentum / Q000637:transplantation*; D010537:Peritoneum; D011183:Postoperative Complications / Q000517:prevention & control; D011446:Prospective Studies; D012007:Rectum / Q000601:surgery*; D012086:Reoperation; D013528:Surgical Staplers