PubMed · 9119815
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N Paslidis, C Torres. 1997. Pseudomembranous colitis.. https://pubmed.ncbi.nlm.nih.gov/9119815/
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INTRODUCTION: Complications related to impaired healing remain a major challenge in colorectal surgery. This review examines the potentially protective role of the greater omentum in colorectal operations. METHODS: Review of all reports concerning applications of the greater omentum in colorectal surgery identified through MEDLINE (1966-1997) and other sources. RESULTS: Clinical case studies indicate that an interposition flap of omentum is beneficial in the management of complex rectal fistulas. Pelvic omentoplasty or an omental hammock appears to reduce the incidence of radiation enteropathy in patients receiving pelvic radiotherapy after rectal resection. However, recent research demonstrates that omental wrapping does not "protect" colonic or rectal anastomoses. Nor is there convincing evidence that pelvic omentoplasty promotes primary perineal healing after abdominoperineal resection for cancer, although it may reduce the incidence of perineal wound breakdown. CONCLUSIONS: Previous assumptions concerning the omentum are now being rigorously investigated with the aim of defining its true value in colorectal applications. This must be encouraged, especially where use of the omentum increases the magnitude or duration of operations significantly.
PURPOSE: Most general surgery residents obtain scant exposure to anorectal disease during training. The aim of this study was to determine whether adding a colon and rectal surgeon to the faculty of a general surgery training program improves the amount or quality of the anorectal surgical experience. METHODS: The surgical experience of all graduating residents from our university teaching program was reviewed during a ten-year period. Complete case data were obtained from the Residency Review Committee for surgery. The total small-intestine, colon and anorectal caseload was analyzed during the five-year period preceding the arrival of the colon and rectal surgeon and compared with the subsequent five-year period after the surgeon's arrival. RESULTS: There was a substantial increase in small-intestine (470 vs. 306) and anorectal cases (462 vs. 338). There was a particularly dramatic increase in anorectal cases performed during the chief resident year (159 vs. 36), which held true for all categories of anorectal cases. CONCLUSIONS: The addition of a full-time colon and rectal surgeon to a university general surgery residency program was associated with an increase in small-intestine and especially anorectal cases. However, most striking was the greater than fourfold increase in the number of anorectal cases performed during the chief resident year. This seems to reflect an increase in complexity of anorectal cases and an increased interest in anorectal surgery among general surgery residents.