Diseases of the Colon & Rectum

, Volume 38, Issue 3, pp 276–280 | Cite as

Effect of omental pedicle hammock in protection against radiation-induced enteropathy in patients with rectal cancer

  • Hong Jo Choi
  • Hyung Sik Lee
Original Contributions
  • 23 Downloads

Abstract

PURPOSE: The aim of this nonrandomized study was to assess effects against radiation-induced enteropathy by constructing an omental pedicle hammock, thus isolating the small bowel outside the pelvis. METHODS: Since 1991, 32 patients received the omental pedicle hammock procedure as an adjunct to definitive cancer surgery, and the perioperative experiences and toxic effects of radiation therapy were evaluated and compared with 25 patients who received pelvic floor reperitonealization only. RESULTS: There were no surgical complications related to the omental hammock procedure. Contrary to control cases that showed the bowel to adhere deeply in the pelvis, exclusion of the small bowel from the pelvic cavity demonstrated by contrast study was successful in all except four cases of a segment of bowel loop descent within the radiation portals. According to acute and late radiation morbidity scoring criteria, 26 patients (81 percent) scored Grade 0 in the treatment group, whereas only 3 patients (12 percent) scored Grade 0 in the control group (P<0.01) in the acute phase, and 28 patients (88 percent) of Grade 0 in the former group and 15 (60 percent) in the latter (P<0.025) in late phase. There has been no case of radiation-induced enteropathy requiring surgical treatment. CONCLUSION: The technique of bowel exclusion by pedicle omental hammock would make it possible to use higher doses of postoperative pelvic radiation therapy without fear of complications from radiation-induced enteropathy.

Key words

Rectal cancer Radiation therapy Omental pedicle hammock Radiation-induced enteropathy 

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Copyright information

© American Society of Colon and Rectal Surgeons 1995

Authors and Affiliations

  • Hong Jo Choi
    • 1
  • Hyung Sik Lee
    • 2
  1. 1.Department of SurgeryDong-A University, College of MedicinePusanSouth Korea
  2. 2.Department of Radiation OncologyDong-A University College of MedicinePusanSouth Korea

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