Robin D Blok1,2, Sarah Sharabiany1, Colin G Ferrett3, Roel Hompes1, Pieter J Tanis4, Christopher Cunningham5. 1. Department of Surgery, Amsterdam University Medical Centres, University of Amsterdam, Post box 22660, 1100 DD, Amsterdam, The Netherlands. 2. LEXOR, Centre for Experimental and Molecular Medicine, Oncode Institute, Cancer Centre Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands. 3. Department of Radiology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK. 4. Department of Surgery, Amsterdam University Medical Centres, University of Amsterdam, Post box 22660, 1100 DD, Amsterdam, The Netherlands. P.J.Tanis@amsterdamumc.nl. 5. Department of Colorectal Surgery, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
Abstract
PURPOSE: This study was designed to examine the impact of an omentoplasty and its quality on pelviperineal morbidity after abdominoperineal resection (APR) for rectal cancer. METHODS: This was a retrospective single-centre study of consecutive patients undergoing APR for primary or recurrent rectal cancer between 2000 and 2018. Quality of omentoplasty was categorised (sufficient vs insufficient) based on postoperative CT scans. Main study endpoints were perineal wound healing and perineal hernia. RESULTS: This study included 100 patients: 16 with a sufficient omentoplasty, 16 with an insufficient omentoplasty, and 68 without omentoplasty. Rate of pelviperineal complications within 30 days was 44%, 69% and 64% (P = 0.283), and delayed wound healing at 3 months was 19%, 54% and 27%, respectively (P = 0.109). Sufficient omentoplasty was not significantly associated with less delayed healing in multivariable analysis (OR 0.597; 95% CI 0.149-2.397). An insufficient omentoplasty demonstrated significantly higher rates of delayed healing at 6 months (46% vs 14%; P = 0.016) and chronic perineal sinus at 12 months (31% vs 3%; P = 0.008) compared with no omentoplasty. CONCLUSION: This relatively small series suggest that even a sufficient omentoplasty, as determined by postoperative imaging, does not reduce pelviperineal morbidity after APR for rectal cancer. The methodology of CT-based assessment of an omentoplasty as well as the correlation with postoperative outcomes has to be validated in future studies.
PURPOSE: This study was designed to examine the impact of an omentoplasty and its quality on pelviperineal morbidity after abdominoperineal resection (APR) for rectal cancer. METHODS: This was a retrospective single-centre study of consecutive patients undergoing APR for primary or recurrent rectal cancer between 2000 and 2018. Quality of omentoplasty was categorised (sufficient vs insufficient) based on postoperative CT scans. Main study endpoints were perineal wound healing and perineal hernia. RESULTS: This study included 100 patients: 16 with a sufficient omentoplasty, 16 with an insufficient omentoplasty, and 68 without omentoplasty. Rate of pelviperineal complications within 30 days was 44%, 69% and 64% (P = 0.283), and delayed wound healing at 3 months was 19%, 54% and 27%, respectively (P = 0.109). Sufficient omentoplasty was not significantly associated with less delayed healing in multivariable analysis (OR 0.597; 95% CI 0.149-2.397). An insufficient omentoplasty demonstrated significantly higher rates of delayed healing at 6 months (46% vs 14%; P = 0.016) and chronic perineal sinus at 12 months (31% vs 3%; P = 0.008) compared with no omentoplasty. CONCLUSION: This relatively small series suggest that even a sufficient omentoplasty, as determined by postoperative imaging, does not reduce pelviperineal morbidity after APR for rectal cancer. The methodology of CT-based assessment of an omentoplasty as well as the correlation with postoperative outcomes has to be validated in future studies.
Authors: Sarah Sharabiany; Saskia I Kreisel; Gaby J Strijk; Robin D Blok; Judith Bosschieter; Ellen T M Laan; Christopher Cunningham; Roel Hompes; Gijsbert D Musters; Pieter J Tanis Journal: Int J Colorectal Dis Date: 2022-08-31 Impact factor: 2.796
Authors: Sarah Sharabiany; Gaby J Strijk; Robin D Blok; Colin G Ferrett; Jaap Stoker; Christopher Cunningham; Jarmila D W van der Bilt; Anna A W van Geloven; Wilhelmus A Bemelman; Roel Hompes; Gijsbert D Musters; Pieter J Tanis Journal: Colorectal Dis Date: 2021-09-08 Impact factor: 3.917
Authors: S Sharabiany; J J W van Dam; S Sparenberg; R D Blok; B Singh; S Chaudhri; F Runau; A A W van Geloven; A W H van de Ven; O Lapid; R Hompes; P J Tanis; G D Musters Journal: Tech Coloproctol Date: 2021-07-14 Impact factor: 3.781