Impact of omentoplasty on anastomotic leak and septic complications after low pelvic anastomosis: a study from the NSQIP database

ÖZBEN V., Ozuner G., Isik Ö., Gorgun E., Stocchi L., Liu X.

INTERNATIONAL JOURNAL OF COLORECTAL DISEASE, cilt.33, sa.12, ss.1733-1739, 2018 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 33 Sayı: 12
  • Basım Tarihi: 2018
  • Doi Numarası: 10.1007/s00384-018-3151-2
  • Dergi Adı: INTERNATIONAL JOURNAL OF COLORECTAL DISEASE
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.1733-1739
  • Anahtar Kelimeler: Omentoplasty, Low pelvic anastomosis, Anastomotic leak, Septic complications, COLORECTAL ANASTOMOSIS, RESECTION, CANCER, METAANALYSIS, PREVENTION, MANAGEMENT
  • Bursa Uludağ Üniversitesi Adresli: Evet

Özet

PurposeThe role of omentoplasty in the prevention of anastomotic leak (AL) in colorectal surgery is controversial. The aim of this study was to evaluate the impact of omentoplasty on AL and septic complications after low pelvic anastomosis using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database.MethodsThe ACS-NSQIP database was queried for patients who underwent segmental colectomy with low pelvic anastomosis by using 2012 targeted colectomy participant use data file. Patients were divided into two groups according to omentoplasty versus no-omentoplasty formation. AL and surgical site infections (SSIs) within postoperative 30days were compared between the groups.ResultsA total of 2891 patients (1447 [50.1%] males) with a mean age of 60.213.0years met the inclusion criteria. There were 86 (2.9%) and 2805 (97.1%) patients in the omentoplasty and no-omentoplasty group, respectively. In the multivariate analysis, omentoplasty neither reduced AL (p=0.83; OR=0.88, 95% CI, 0.21-2.44) nor organ/space SSIs (p=0.08; OR=2.14, 95% CI, 0.91-4.41). Also, this technique did not play any role in reducing AL and organ/space SSI rates regardless of diversion with the exception of its association with higher organ/space SSIs in patients without diverting stoma (9.2% vs 3.8%, p=0.04). No differences were detected between the groups with respect to the management strategies for AL (p=0.22).ConclusionsOmentoplasty did not decrease AL and septic complications after low pelvic anastomosis and had no impact on the postoperative management of AL.