Nilsson Per J
Department of Clinical Science, Intervention and Technology, Karolinska Institute and Centre of Gastrointestinal Disease, Ersta Hospital, P.O. Box 4622, SE 116 91 Stockholm, Sweden.
Dis Colon Rectum. 2006 Sep;49(9):1354-61. doi: 10.1007/s10350-006-0643-x.
Abdominoperineal resection is associated with considerable morbidity, in particular, the perineal wound. Omentoplasty has been proposed as a means of reducing the perineal complication rate after abdominoperineal resection. This study was designed to assess the available evidence for omentoplasty in abdominoperineal resection.
A MEDLINE search from January 1970 to July 2005 was performed to locate English language articles relating to omentoplasty in abdominoperineal resection. Manual search via reference lists identified additional articles. Articles reporting results from at least ten patients in whom abdominoperineal resection with an omentoplasty was performed were considered. All included reports were reviewed by using a predetermined protocol.
Among the ten reports identified, no randomized trials, four studies with control groups, and six case series were found. Primary healing was the outcome measure that was most consistently reported in the different articles. Most authors reported positive results after omentoplasty, and one study showed significant improvement in perineal healing rate at six months. Significant reduction in sinus formation and wound dehiscence also was reported. Only few complications related to the omentoplasty, none of which was fatal, were reported.
Although results from the studies included in this review indicate that there may be benefits from including an omentoplasty when performing an abdominoperineal resection, the lack of randomized studies results in only weak evidence.
腹会阴联合切除术伴有相当高的发病率，尤其是会阴伤口。网膜成形术已被提议作为降低腹会阴联合切除术后会阴并发症发生率的一种方法。本研究旨在评估网膜成形术用于腹会阴联合切除术的现有证据。
对1970年1月至2005年7月期间的MEDLINE进行检索，以查找与腹会阴联合切除术中网膜成形术相关的英文文章。通过参考文献列表进行手工检索以确定其他文章。纳入至少10例行腹会阴联合切除术并进行网膜成形术患者的报告。所有纳入的报告均按照预定方案进行审查。
在检索到的10篇报告中，未发现随机试验，4项有对照组的研究，以及6个病例系列。一期愈合是不同文章中最常报告的结局指标。大多数作者报告网膜成形术后有阳性结果，一项研究显示6个月时会阴愈合率有显著改善。也有报告窦道形成和伤口裂开显著减少。仅报告了少数与网膜成形术相关的并发症，且无一例致命。
尽管本综述纳入的研究结果表明，在进行腹会阴联合切除术时采用网膜成形术可能有益，但缺乏随机研究导致证据不足。
