Analysis of presacral tissue structure in LARS and the prevention of LARS by reconstruction of presacral mesorectum with pedicled greater omentum flap graft

Background The greater omentum has played a unique biological role in regenerative surgery. The aim of our study was to alter the anterior sacral structure by filling the anterior sacral space with the greater omentum and evaluate its effect on the low anterior resection syndrome (LARS) after total...

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Bibliographic Details
Published in:Techniques in coloproctology 2021-12, Vol.25 (12), p.1291-1300
Main Authors: Meng, Linghou, Qin, Haiquan, Huang, Zigao, Liao, Jiankun, Cai, Jinghua, Feng, Yan, Luo, Shanshan, Lai, Hao, Tang, Weizhong, Mo, Xianwei
Format: Article
Language:English
Subjects:
Abdominal Surgery
Adult
Aged
Colorectal cancer
Colorectal Surgery
Correlation analysis
Gastroenterology
Humans
Male
Medicine
Medicine & Public Health
Middle Aged
Omentum - surgery
Original Article
Ostomy
Postoperative Complications - etiology
Postoperative Complications - prevention & control
Proctology
Rectal Neoplasms - surgery
Retrospective Studies
Surgery
Syndrome
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Summary:Background The greater omentum has played a unique biological role in regenerative surgery. The aim of our study was to alter the anterior sacral structure by filling the anterior sacral space with the greater omentum and evaluate its effect on the low anterior resection syndrome (LARS) after total mesorectal excision (TME) surgery for low rectal cancer. Methods We retrospectively collected clinical data of patients with primary low rectal cancer who underwent TME and ileostomy closure in our hospital from March 2018 to March 2020. Spearman correlation analysis was conducted to analyze the correlation between postoperative mesorectal fascia (MRF) thickness and LARS score. Subsequently, we prospectively used a tipped greater omental flap graft to reconstruct the anterior rectal sacral structures (MRF reconstruction) in 17 patients and compared LARS scores and rectal compliance (RC) at week 12 after closure of the ileostomy in both groups. Results There were 47 patients with No-MRF reconstruction (31 males, mean age 60.68 ± 9.21 years) and 17 with MRF reconstruction (10 males, mean age 49.82 ± 14.74 years). Correlation analysis indicated that MRF thickness and RC were negatively correlated with LARS severity ( p  
ISSN:1123-6337
1128-045X
DOI:10.1007/s10151-021-02521-9