[Clinical effects of pedicled omentum covering and wrapping the ureteral anastomosis to prevent ureteral anastomotic leakage after surgery of abdominal and pelvic tumors].
OBJECTIVE
To explore the clinical effects of pedicled omentum covering and wrapping the ureteral anastomosis to prevent ureteral anastomotic leakage after surgery of abdominal and pelvic tumors.


METHODS
Clinical data of 64 patients with ureteral anastomosis after surgery of abdominal and pelvic tumors treated in our department from May 2005 to May 2012 were retrospectively analyzed. They were assigned into 2 groups. There were 23 patients of ureteral anastomosis combined with pedicled omentum surrounding and wrapping the anastomotic site (optimization group), and 41 cases of ureteral anastomosis alone (control group). The clinical data of all the 64 patients were reviewed and the therapeutic effects of the two treatment approaches were compared.


RESULTS
At one week after the operation, there were 8 cases (34.8%, 8/23) with ureteral anastomotic fistula in the optimization group and 31 cases (75.6%, 31/41) in the control group (P = 0.010). In the postoperative days 1-3, the average drainage everyday from abdominal tube around the anastomotic site was 260.4 ml and 320.8 ml, respectively (P = 0.446). The average drainage volume everyday was 80.5 ml and 160.5 ml from the postoperative day 4 to day 7 (P = 0.015). The average time of removal of the peritoneal cavity drainage tube was 18.5 d in the optimization group and 32.6 d postoperatively in the control group (P = 0.015).


CONCLUSIONS
Covering and wrapping the ureteral anastomosis with pedicled omentum can promote the rapid adhesion of surrounding tissues to reduce urine leakage and postoperative complications, and shorten the surgical treatment cycle.
Department of General Surgery, Affiliated Tumor Hospital of Zhengzhou University (Henan Tumor Hospital), Zhengzhou 450008, China.
Gangcheng
G
Wang
Department of General Surgery, Affiliated Tumor Hospital of Zhengzhou University (Henan Tumor Hospital), Zhengzhou 450008, China. Email: hnhanguangsen@126.com.
Guangsen
G
Han
Department of General Surgery, Affiliated Tumor Hospital of Zhengzhou University (Henan Tumor Hospital), Zhengzhou 450008, China.
Yingkun
Y
Ren
Department of General Surgery, Affiliated Tumor Hospital of Zhengzhou University (Henan Tumor Hospital), Zhengzhou 450008, China.
Yong
Y
Cheng
Department of General Surgery, Affiliated Tumor Hospital of Zhengzhou University (Henan Tumor Hospital), Zhengzhou 450008, China.
Yongchao
Y
Xu
Department of General Surgery, Affiliated Tumor Hospital of Zhengzhou University (Henan Tumor Hospital), Zhengzhou 450008, China.
Yuzhou
Y
Zhao
Department of General Surgery, Affiliated Tumor Hospital of Zhengzhou University (Henan Tumor Hospital), Zhengzhou 450008, China.
Jian
J
Zhang
Department of General Surgery, Affiliated Tumor Hospital of Zhengzhou University (Henan Tumor Hospital), Zhengzhou 450008, China.
Chaomin
C
Lu
D000008:Abdominal Neoplasms / Q000601:surgery; D000368:Aged; D000714:Anastomosis, Surgical / Q000009:adverse effects*; D057868:Anastomotic Leak / Q000209:etiology / Q000517:prevention & control*; D004322:Drainage / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009852:Omentum / Q000601:surgery*; D010386:Pelvic Neoplasms / Q000601:surgery; D012189:Retrospective Studies; D014513:Ureter