The use of an omental pedicle graft to prevent small-bowel obstruction after restorative proctocolectomy.

Abstract:

:Small-bowel obstruction remains one of the most frequent complications after restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA). Of particular concern is small-bowel adhesion to the pelvic dead space that causes afferent limb obstruction, sometimes necessitating laparotomy. In this report, we describe a technique using an omental pedicle graft (OPG) to fill the pelvic dead space to prevent small-bowel obstruction and the resulting afferent limb obstruction after IPAA. The OPG is created from the left half of the omentum, while maintaining the blood supply from the left gastroepiploic vessels. The omentum is placed into the pelvis along the left paracolic gutter from where the colon has been resected. It is then passed over the pelvic brim and placed behind and along the bilateral sides of the ileal pouch, filling the space. This modified technique was employed in the treatment of four patients with chronic ulcerative colitis, none of whom developed any signs of small-bowel obstruction.

journal_name

Surg Today

journal_title

Surgery today

authors

Nakagoe T,Sawai T,Tuji T,Nanashima A,Yamaguchi H,Yasutake T,Ayabe H

doi

10.1007/BF02483074

subject

Has Abstract

pub_date

1999-01-01 00:00:00

pages

395-7

issue

4

eissn

0941-1291

issn

1436-2813

pii

10.1007/BF02483074

journal_volume

29

pub_type

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