PURPOSE: The aim of this study was to investigate the role of omentoplasty,
by means of intact omentum, in preventing anastomotic leakages after recta
l resection. METHODS: Between 1992 and 1997 a total of 112 patients (64 mal
es) with a mean age of 64.7 (range, 39-83) years were randomly assigned to
undergo omentoplasty (Group A) or not (Group B) to reinforce the colorectal
anastomosis after anterior resection for rectal cancer. The primary end po
int was anastomotic leakage; the secondary end point included morbility and
mortality related to omentoplasty. RESULTS: The two groups were comparable
in terms of preoperative and intraoperative characteristics. Staple-ring d
isruption at plain abdominal radiographs was detected in seven instances in
Group A and in ten in Group B patients (P = not significant). Two leakages
were evident clinically in Group A and seven in Group B (P < 0.05). Three
leaks were documented radiologically in Group A and eight in Group B (P = n
ot significant). No complications related to omentoplasty were observed in
Group A. There were two repeat operations for anastomotic leakage in Group
B. At follow-up, one stricture developed in Group A and three in Group B (P
= not significant) CONCLUSIONS: Despite a similar incidence of staple-ring
defects, a strikingly lower rate of clinically and radiologically detected
leaks developed in patients submitted to omentoplasty. Although not affect
ing the incidence of anastomotic disruption, omentoplasty seems to contain
the severity of anastomotic leakage.