ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
The use of pedicled omentum flap in the prevention of esophagogastric anastomotic leak in esophageal cancer
Yener Aydın1, Atila Türkyılmaz1, Atilla Eroğlu1, Hacı Ahmet Alıcı2, Nurettin Karaoğlanoğlu3
1Department of Thoracic Surgery, Medicine Faculty of Atatürk University, Erzurum
2Department of Anesthesiology and Intensive Care, Medicine Faculty of Atatürk University, Erzurum
3Department of Thoracic Surgery, Atatürk Training and Research Hospital for Chest Disease and Chest Surgery, Ankara
Background: In this study, we investigate the effectiveness of the pedicled omental flap in preventing leakage after Ivor Lewis (transthoracic) type esophagectomy.

Methods: The records of 132 patients (48 males, 84 females; mean age 56.7±12.5 years; range 16 to 80 years), in whom Ivor Lewis-type esophagectomy and esophagogastric anastomosis were performed between January 2000 and December 2007 in the Department of Thoracic Surgery of the Atatürk University Medical Faculty Hospital, were evaluated retrospectively. Esophagogastric anastomosis was made in the thorax and stomach was chosen for reconstruction. The esophagogastric anastomosis and gastric suture line were wrapped with a pedicled omental flap.

Results: Complications developed in 65 patients (49.2%). Anastomotic leak developed in five patients (3.8%). Hospital mortality rate (30-day mortality rate) was 5.3% (n=7). Primary causes of mortality were anastomotic leak and respiratory failure. Mean hospital stay after operation was 13.8 days. Three and five year survival rates of the patients were 39.5% and 19.6% respectively.

Conclusion: According to our clinical experiences, the use of pedicled omentum in esophagogastric anastomosis significantly reduces the incidence of anastomotic leak after esophagogastrectomy for carcinoma of the esophagus.

Keywords : Blood supply; esophageal cancer; esophagectomy; gastrectomy; omentoplasty; omentum/surgery; surgical flap
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