Omentoplasty, an important technique to prevent complications following esophagectomy: a comparative study

• Published in: Indian journal of thoracic and cardiovascular surgery Vol. 32; no. 4; pp. 239 - 243
• Main Authors: Ahmad, Tawheed, Jan, Summaira, Rashid, Saima, Langoo, Shabir Ahmad
• Format: Journal Article
• Language: English
• Published: New Delhi Springer India 01.12.2016
• Subjects: Cardiac Surgery; Medicine; Medicine & Public Health; Original Article; Surgery; Thoracic Surgery; Vascular Surgery; Esophagogastric anastomosis; Anastomotic leakage; Omentoplasty
• ISSN: 0970-9134; 0973-7723
• DOI: 10.1007/s12055-016-0464-z

Purpose One of the important modes of treatment for esophageal carcinoma is surgical resection with esophagogastric anastomosis. Anastomotic leakage is a very common complication which adds to both morbidity and mortality following this procedure. In our study, we evaluated the effect of omentoplasty on complication rates following esophagectomy in esophageal carcinoma patients. Settings and design This is a prospective randomised controlled study. Methods This study was conducted on 110 patients who underwent esophagectomy with esophagogastric anastomosis for esophageal carcinoma. Patients were randomly assigned to two treatment groups (A and B) with 55 patients in each group. In patients of group A (study group), omental wrapping was done over esophagogastric anastomosis, whereas no omentoplasty was done over anastomotic site in patients of group B (control group). Results Anastomotic leakage occurred in one patient (1.8 %) of group A while ten patients (18.2 %) of group B developed anastomotic leakage. The difference in rate of anastomotic leakage between the two groups was statistically significant ( P  = 0.004). Anastomotic stricture developed in six patients (10.9 %) of group A and in four patients (7.3 %) of group B; however, the difference in rate of developing anastomotic stricture between the two groups was statistically insignificant ( P  = 0.509). In-hospital mortality rate was 3.6 % in group A and 5.5 % in group B; however, difference in mortality rate between the two groups was statistically insignificant ( P  = 0.649). Conclusions Addition of omentoplasty over esophagogastric anastomosis significantly decreases the rate of anastomotic leakage and related morbidity.