Abstract
A surgical aphorism has long held that the omentum is the “watchdog of the abdomen.” However, detractors believe that leaving the omentum behind after colectomy precipitates later small bowel obstruction. A retrospective comparison was made between a group of 406 patients (Group I) having omentectomy with proctocolectomy and ileoanal anastomosis and a group of 239 patients (Group II) having a similar procedure without omentectomy. Follow-up in this series of 645 patients was 4.3±2.1 years (mean ± SEM). No difference was present in the rate of partial small bowel obstruction or complete small bowel obstruction between Group I patients (32 percent partial, 12 percent complete) and Group II patients (29 percent partial, 12 percent complete; P> 0.1). However, a better outcome with regard to postoperative sepsis and sepsis requiring operation was apparent in Group II patients retaining the omentum (4 percent and 3 percent, respectively) than in Group I patients (10 percent and 8 percent, respectively), in whom the omentum was removed (P<0.01). As this experience would support, we urge surgeons to “let sleeping dogs lie” and, when possible, retain the omentum when performing colectomy or proctocolectomy.
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Mishalany HG. Can the omentum produce intestinal obstruction? J Med Liban 1972;25:209–14.
Pemberton JH, Kelly KA, Beart RW Jr, Dozois RR, Wolff BG, Ilstrup DM. Ileal pouch-anal anastomosis for chronic ulcerative colitis: long-term results. Ann Surg 1987;206:504–13.
Trooskin SZ, Pierce RA, Deak SB,et al. The effect of viable omentum on early bile leakage and healing of liver lacerations. J Trauma 1989;29:47–50.
Durig M, Liebermann A. Physiology and functions. In: Liebermann-Meffert D, White H, eds. The greater omentum. Berlin: Springer-Verlag, 1983:63–89.
Weese JL, Ottery FD, Emoto SE. Does omentectomy prevent malignant small bowel obstruction? Clin Exp Metastasis 1988;6:319–24.
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Read at the meeting of The American Society of Colon and Rectal Surgeons, St. Louis, Missouri, April 29 to May 4, 1990.
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Ambroze, W.L., Wolff, B.G., Kelly, K.A. et al. Let sleeping dogs lie: Role of the omentum in the ileal pouch-anal anastomosis procedure. Dis Colon Rectum 34, 563–565 (1991). https://doi.org/10.1007/BF02049895
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DOI: https://doi.org/10.1007/BF02049895