Omentoplasty versus cecal mobilization after abdominoperineal resection: A propensity score matching analysis.

Background: Despite the minimally invasive approach and early rehabilitation, abdominal-perineal resection (APR) remains a procedure with high morbidity, notably due to postoperative trapped bowel ileus and perineal healing complications. Several surgical techniques have been described for filling the pelvic void to prevent abscess formation and ileus by trapped bowel loop.

Objective: The aim of our study was to compare the post APR complications for cancer of two of these techniques, omentoplasty and cecal mobilization, in a single-center study from an expert colorectal surgery center.

Patients: From 2012 to 2022, 84 patients were included, including 58 (69%) with omentoplasty and 26 (31%) with cecal mobilization. They all underwent APR at Bordeaux University Hospital Center.

Settings: A propensity score was used to avoid confounding factors as far as possible. Patient and procedure characteristics were initially comparable.

Results: The 30-day complication rate was significantly higher in the cecal mobilization group (53.8% vs. 5.2% p < 0.01), as was the rate of pelvic abscess (34.6% vs. 0% p < 0.001).

Conclusion: These findings suggest that, when feasible, omentoplasty should be considered the preferred method for pelvic reconstruction following APR.