Association of omental pedicled flap with anastomotic leak following low anterior resection for rectal cancer

Author:

Ali Danish1ORCID,Syed Maria1,Gamboa Adriana C.2,Hawkins Alexander T.3,Regenbogen Scott E.4,Holder‐Murray Jennifer5,Silviera Matthew6,Ejaz Aslam7ORCID,Balch Glen C.2,Khan Aimal3

Affiliation:

1. Department of Surgery Aga Khan University Hospital Karachi Pakistan

2. Department of Surgery Emory University Atlanta Georgia USA

3. Department of Surgery, Section of Surgical Sciences Vanderbilt University Medical Center Nashville Tennessee USA

4. Department of Surgery University of Michigan Ann Arbor Michigan USA

5. Department of Surgery University of Pittsburgh Medical Center Pittsburgh Pennsylvania USA

6. Department of Surgery Washington University School of Medicine St. Louis Missouri USA

7. Department of Surgery The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center Columbus Ohio USA

Abstract

AbstractBackground and ObjectivesAnastomotic leak following colorectal anastomosis adversely impacts short‐term, oncologic, and quality‐of‐life outcomes. This study aimed to assess the impact of omental pedicled flap (OPF) on anastomotic leak among patients undergoing low anastomotic resection (LAR) for rectal cancer using a multi‐institutional database.MethodsAdult rectal cancer patients in the US Rectal Cancer Consortium, who underwent a LAR for stage I–III rectal cancer with or without an OPF were included. Patients with missing data for surgery type and OPF use were excluded from the analysis. The primary outcome was the development of anastomotic leaks. Multivariable logistic regression was used to determine the association.ResultsA total of 853 patients met the inclusion criteria and OPF was used in 106 (12.4%) patients. There was no difference in age, sex, or tumor stage of patients who underwent OPF versus those who did not. OPF use was not associated with an anastomotic leak (p = 0.82), or operative blood loss (p = 0.54) but was associated with an increase in the operative duration [β = 21.42 (95% confidence interval = 1.16, 41.67) p = 0.04].ConclusionsAmong patients undergoing LAR for rectal cancer, OPF use was associated with an increase in operative duration without any impact on the rate of anastomotic leak.

Publisher

Wiley

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