Does omental pedicle flap reduce anastomotic leak and septic complications after rectal cancer surgery?

• This study evaluated the role of omental pedicle flap (OPF) creation on anastomotic leak and septic complications in rectal cancer surgery.
• Patients were categorized into two groups based on OPF versus no-OPF creation.
• OPF did not have any impact on the rates of anastomotic leak and septic complications nor in the management of anastomotic leak.

IntroductionWhether creation of omental pedicle flap (OPF) to reinforce bowel anastomosis can reduce septic outcomes remains controversial. The aim of this study was to investigate the role of this technique on anastomotic leak and septic complications after rectal cancer surgery.MethodsPatients who underwent rectal cancer surgery from 01/2008 to 12/2013 were identified and categorized into two groups based on OPF creation versus no-OPF creation. Clinical, operative characteristics and postoperative anastomotic leak and surgical site infections within 30 days after surgery were compared between the groups.ResultsThere were 65 (14%) and 403 (86%) patients in OPF and no-OPF group, respectively. In multivariate analysis, OPF was not found to be associated with anastomotic leak (p = 0.35), organ/space infections (p = 0.99) and overall surgical site infections (p = 0.65). Three hundred and sixty eight (78.6%) patients underwent diversion. OPF did not reduce septic complications irrespective of the stoma status (p > 0.05). There were no differences between the two groups in terms of operative (p = 0.46) and non-operative management (p = 0.14).ConclusionOPF neither reduced the incidence of anastomotic leak and surgical site infections nor had any impact on the management of anastomotic leak.