The influence of omentectomy on the inflammatory phase of anastomotic healing.

Hepatogastroenterology

Department of Surgery, Cerrahpasa Medical School, Istanbul University, Istanbul, Turkey.

Published: February 2002

Background/aims: Proper wound healing of the alimentary tract is essential for the prevention of the significant mortality and morbidity associated with complications. The effects of omentectomy on the inflammatory phase of anastomotic healing in rats were examined.

Methodology: Sixty male Wistar-Albino rats that weighed about 200-220 g were used in this study. Animals were divided into three groups as colon anastomosis, colon anastomosis + partial omentectomy and colon anastomosis + total omentectomy. On the third postoperative day, all animals were sacrificed under anesthesia. Bursting pressure of anastomosis amounts and types of cells in the anastomosis, and nitric oxide, malondialdehyde, superoxide dismutase levels in the anastomosis and serum was examined.

Results: Bursting pressure values were 102.60 +/- 13.41 mm Hg, 105 +/- 10.80 mm Hg and 102.50 +/- 11.12 mm Hg in the colon anastomosis, colon anastomosis + partial omentectomy and colon anastomosis + total omentectomy groups, respectively (P > 0.05). A significant increase in macrophage count was found in the colon anastomosis + total omentectomy group when compared with the colon anastomosis group (P = 0.02). According to the comparisons with percentages, there was a significant difference in lymphocyte counts between colon anastomosis and colon anastomosis + total omentectomy groups (P = 0.04). The blood level of superoxide dismutase was higher in the colon anastomosis + total omentectomy group than the other two groups, and in the colon anastomosis + partial omentectomy group than the colon anastomoses group (P = 0.0001). There was a significant increase in the blood level of nitric oxide when comparing the colon anastomosis + total omentectomy group with colon anastomosis group (P = 0.02). The tissue level of malondialdehyde was higher in the colon anastomosis + total omentectomy group than the other two groups (P < 0.0001).

Conclusions: Omentectomy may influence the outcome of the inflammatory phase of wound healing in rats. But systemic compensatory regulation of body can tolerate these detrimental effects and wound healing continues in its regular manner.

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