Maeda M, Matsuzaki Y, Edagawa M, Shimizu T, Onitsuka T
Department of Surgery II, Miyazaki Medical College, 5200 Kihara, Kiyotake, Miyazaki 889-1692, Japan.
Ann Thorac Cardiovasc Surg. 1999 Aug;5(4):220-4.
A retrospective evaluation on the usefulness of the pedicled omental graft (POG) in treating problems associated with thoracic surgery is reported. The omentum has been long used to manage numerous intra-abdominal problems because of its excellent blood supply that could limit the spread of infection. The POG finds even greater application in extraperitoneal use because it is able to extend to all areas of the thorax. In this study, we reviewed 25 patients with omentopexy cases in our thoracic surgery unit over the last 19 years. Indications and usage of the POG were divided into two categories. As a preventive measure, the POGs were used to wrap tracheal and bronchial anastomoses. As a corrective treatment, the POGs were used to wrap perforated esophageal lesions and bronchial stumps and cover postoperative bronchial and pulmonary fistulas, repair chest walls, fill empyema cavities, and control osteomyelitis in the sternum and ribs. Uneventful and successful treatments were obtained in 22 cases (88%). Two patients died due to multiple organ failure followed by sepsis, and another due to respiratory failure. The POG was considered to be effective and useful in treating both potential and existing conditions often encountered in thoracic surgery.
本文报告了一项关于带蒂大网膜移植术（POG）在治疗胸外科相关问题中的应用价值的回顾性评估。大网膜因其良好的血供能够限制感染扩散，长期以来一直用于处理多种腹腔内问题。POG在腹膜外的应用更为广泛，因为它能够延伸至胸部的各个区域。在本研究中，我们回顾了过去19年里在我们胸外科接受大网膜固定术的25例患者。POG的适应证和用法分为两类。作为一种预防措施，POG用于包裹气管和支气管吻合口。作为一种矫正治疗，POG用于包裹穿孔性食管病变和支气管残端，覆盖术后支气管和肺瘘，修复胸壁，填充脓腔，并控制胸骨和肋骨的骨髓炎。22例（88%）患者治疗顺利且成功。2例患者因多器官功能衰竭继发脓毒症死亡，另1例因呼吸衰竭死亡。POG被认为在治疗胸外科常见的潜在和现有病症方面是有效且有用的。
