|
KMID : 0365719930090010036
|
|
Journal of Pusan Surgical Society
1993 Volume.9 No. 1 p.36 ~ p.45
|
|
|
The Omental Trasposition Flap in Rectal Carcinoma
|
|
|
|
|
Abstract
|
|
|
Patients with rectal carcinoma above the modified Dukes' stage B2 are candidates for the adjuvant postoperative radiotherapy in order to prevent locoregional recurrences. The postoperative rediotherapy with tumoricidal doses, however, frequently
contributes to significant incidence of radiation-associated small bowel injury (RASBI) in a dose dependent manner.
Author preliminarily reviewed 11 experiences of the use of the greater omentum as a transposition pedicle flap based on the left gastroepiploic artery elevating the small bowel away from the pelvic cavity to maximize the therapeutic ratio of
radiation
therapy for locoregional control of rectal carcinoma without the fear of RASBI.
Totally 11 cancer surgeries (abdominoperineal resection in 8 patients, low anterior resection in 2 patients and posterior pelvic exentration in 1 patient) were performed in 11 patients with rectal carcinomas, and every patient received adjuvant
postoperative radiotherapy with the mean dose of 54.0 Gy. The postoperative ileus periods were 3-7 days (mean 4.9 days) and there was no immediate complications related to the flap procedures. With the exception of one patient who showed some
inadequate
elevation with a segmental descent of the small bowel on the small bowel series and developed RASBI-like clinical findings, there was no documented incidence of clinical RASBI.
The safety, effectiveness and ease of this procedure has allowed to use sufficient tumoricidal doses of the postoperative radiotherapy without the associated hazard of RASBI, which led the author to recom mend to use the omental transposition
flap
for
every patient with rectal carcinoma above modified Dukes' stage B2.
|
|
|
KEYWORD
|
|
|
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
|
|
|