title: Does omental pedicle flap reduce anastomotic leak and septic complications after rectal cancer surgery?
abstract: BACKGROUND
  Whether creation of omental pedicle flap (OPF) to reinforce bowel anastomosis can reduce septic outcomes remains controversial. The aim of this study was to investigate the role of this technique on anastomotic leak and septic complications after rectal cancer surgery.
  
  
  METHODS
  Patients who underwent rectal cancer surgery from 01/2008 to 12/2013 were identified and categorized into two groups based on OPF creation versus no-OPF creation. Clinical, operative characteristics and postoperative anastomotic leak and surgical site infections within 30 days after surgery were compared between the groups.
  
  
  RESULTS
  There were 65 (14%) and 403 (86%) patients in OPF and no-OPF group, respectively. In multivariate analysis, OPF was not found to be associated with anastomotic leak (p = 0.35), organ/space infections (p = 0.99) and overall surgical site infections (p = 0.65). Three hundred and sixty eight (78.6%) patients underwent diversion. OPF did not reduce septic complications irrespective of the stoma status (p > 0.05). There were no differences between the two groups in terms of operative (p = 0.46) and non-operative management (p = 0.14).
  
  
  CONCLUSIONS
  OPF neither reduced the incidence of anastomotic leak and surgical site infections nor had any impact on the management of anastomotic leak.
authors.affiliation: Department of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Volkan
authors.initials: V
authors.lastname: Ozben
authors.affiliation: Department of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Erman
authors.initials: E
authors.lastname: Aytac
authors.affiliation: Section of Biostatistics, Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Xiaobo
authors.initials: X
authors.lastname: Liu
authors.affiliation: Department of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH, USA. Electronic address: ozunerg@ccf.org.
authors.forename: Gokhan
authors.initials: G
authors.lastname: Ozuner
mesh_terms: D000368:Aged; D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000379:methods; D057868:Anastomotic Leak / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009852:Omentum / Q000601:surgery*; D012004:Rectal Neoplasms / Q000601:surgery*; D012189:Retrospective Studies; D013524:Surgical Flaps; D054047:Surgical Stomas / Q000009:adverse effects; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control
keywords: Anastomotic leak; Omental pedicle flap; Rectal cancer surgery; Surgical site infections