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Clinical Imaging Sep 2023The greater omentum is a unique anatomical structure that serves a critical function in the containment of inflammatory and infectious processes within the abdominal... (Review)
Review
The greater omentum is a unique anatomical structure that serves a critical function in the containment of inflammatory and infectious processes within the abdominal cavity. It is also a common site of involvement by metastases, as well as the primary location for various pathologic lesions of clinical significance. Its fibroadipose composition, large size, and position in the most anterior aspect of abdomen allow accurate visualization of the greater omentum on CT and MR images. Careful evaluation of the greater omentum can provide important clues to the diagnosis of the underlying abdominal disorder. The aim of this article is to present the normal appearance of the greater omentum, and the wide spectrum of its pathological features as demonstrated on CT and MRI of the abdomen.
Topics: Humans; Omentum; Tomography, X-Ray Computed; Mesentery; Magnetic Resonance Imaging; Adipose Tissue
PubMed: 37290177
DOI: 10.1016/j.clinimag.2023.05.014 -
The Journal of Trauma and Acute Care... Dec 2020
Review
Topics: History, Ancient; Humans; Immunity; Laparotomy; Omentum
PubMed: 32925575
DOI: 10.1097/TA.0000000000002945 -
World Journal of Surgery Aug 2022Since 1910, omentectomy has been an essential component of radical gastrectomy for advanced gastric cancer. However, researchers have recently questioned the benefit of... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Since 1910, omentectomy has been an essential component of radical gastrectomy for advanced gastric cancer. However, researchers have recently questioned the benefit of omentectomy in radical gastrectomy. The aim of this meta-analysis was to compare omentectomy and omentum preservation in gastrectomy for advanced gastric cancer in terms of survival outcomes and short-term outcomes.
METHODS
The PubMed, Embase, Web of Science, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov databases were searched. Studies that compared omentum preservation with omentectomy were included. Overall survival (OS) and relapse-free survival (RFS) were analyzed as primary outcomes.
RESULTS
Of 3509 records screened, one randomized clinical trial and five propensity-score matched retrospective studies with 1661 patients were selected. Omentum preservation was associated with improved OS (hazard ratio [HR] = 0.757, 95% confidence interval [CI] = 0.603-0.950, P = 0.016, I = 0%), but not with improved RFS (HR = 0.821, 95% CI = 0.668-1.009, P = 0.060, I = 9%) compared with omentectomy for advanced gastric cancer. Furthermore, less blood loss and shorter operation time were found in the omentum preservation group than in the omentectomy group. Additionally, the rate of peritoneal recurrence, the number of harvested lymph nodes, and the incidences of postoperative complications and ileus were comparable in the two groups.
CONCLUSIONS
Basing on the current literature, gastrectomy with omentum preservation was associated with improved OS and short-term outcomes compared with omentectomy for advanced gastric cancer. Further randomized trials are required to confirm the survival benefit of omentum-preserving gastrectomy.
Topics: Gastrectomy; Humans; Neoplasm Recurrence, Local; Omentum; Randomized Controlled Trials as Topic; Retrospective Studies; Stomach Neoplasms
PubMed: 35462593
DOI: 10.1007/s00268-022-06562-5 -
Medicine Sep 2022The extrauterine adenomyoma is rare and it is extremely rare outside the pelvic cavity. Herein, we reported the first case of a single extrauterine adenomyoma occurring... (Review)
Review
RATIONALE
The extrauterine adenomyoma is rare and it is extremely rare outside the pelvic cavity. Herein, we reported the first case of a single extrauterine adenomyoma occurring in the lesser omentum.
PATIENTS CONCERNS
This case involved a 55-year-old woman who had undergone subtotal gastrectomy and omentectomy for gastric carcinoma. During postoperational pathological examination, 1 lymph node-like mass was coincidentally found in the lesser omentum. The patient had a history of hysterectomy for uterine leiomyoma 8 years ago.
DIAGNOSES
The resected 17 "lymph nodes" from the lesser omentum were routinely checked for possible metastasis of gastric carcinoma. One of lymph node-like mass was microscopically showed that it was composed of benign smooth muscle components, endometrial glands and stroma by HE staining. Therefore, adenomyoma was initially considered.
INTERVENTIONS
The lymph node-like mass was removed together with the lesser omentum during the subtotal gastrectomy and omentectomy for gastric carcinoma. No special intervention was performed for the adenomyoma.
OUTCOMES
Immunohistochemical staining confirmed that smooth muscle tissue was diffusely and strongly positive for Desmin, smooth muscle actin, estrogen receptor, and progesterone receptor, and negative for CD117, Dog-1, S100, and CD34. Endometrial glands and stroma were positive for estrogen receptor and progesterone receptor, and the endometrium interstitium was also positive for CD10. The final diagnosis of extrauterine adenomyoma occurring in the lesser omentum was established.
LESSONS
So far, to the best of our knowledge, total 53 cases of extrauterine adenomyoma have been reported in 45 English reports. The most common location for a single mass was pelvic cavity (37 cases), but rarely outside the pelvic cavity. This is the first case of a single extrauterine adenomyoma occurring in the lesser omentum.
Topics: Adenomyoma; Carcinoma; Female; Humans; Omentum; Receptors, Estrogen; Receptors, Progesterone
PubMed: 36086793
DOI: 10.1097/MD.0000000000030240 -
Pediatric Radiology Jul 2017The normal peritoneal structures, including the mesenteries and the omenta, are only a few cell layers thick and are visible on imaging based upon the tissues (e.g.,... (Review)
Review
The normal peritoneal structures, including the mesenteries and the omenta, are only a few cell layers thick and are visible on imaging based upon the tissues (e.g., fat) and structures (e.g., blood vessels and lymph nodes) contained within them. These structures become more visible and change in appearance when involved by pathological processes. In this pictorial essay, we discuss the normal anatomy of the various abdominopelvic peritoneal structures and illustrate numerous developmental and acquired diagnoses that involve these structures in the pediatric and young adult population.
Topics: Child; Humans; Mesentery; Omentum; Peritoneum
PubMed: 28646385
DOI: 10.1007/s00247-017-3864-3 -
Gynecologic Oncology Dec 2013This article reviews the literature concerning the function of the omentum and how omentectomy came to be part of the staging and treatment of epithelial ovarian cancer. (Review)
Review
OBJECTIVE
This article reviews the literature concerning the function of the omentum and how omentectomy came to be part of the staging and treatment of epithelial ovarian cancer.
METHODS
A review of the English language literature based on a MEDLINE (PubMed) database search using the key words: ovary, cancer, carcinoma, omentum, and omentectomy. An additional collection of reports was found by systematically reviewing all references from retrieved papers.
RESULTS
Descriptions of the omentum can be found as far back as the time of the ancient Egyptians. An immunologic role of the omentum was confirmed in 1980s when "milky spots" were described. Omentectomy arrived as part of the ovarian cancer guidelines in the 1960s after observing that the omentum was a frequent site of metastasis and that patients with removal of all diseased tissue did better. The exact role of the omentum in immunology and cancer remains incompletely understood.
CONCLUSIONS
Historically, occult omental metastases in otherwise early disease have led to the inclusion of omentectomy for the purpose of accurate staging and for a possible therapeutic benefit. Laboratory studies on the role in cancer of the omental fat and milky spots are controversial.
Topics: Animals; Carcinoma, Ovarian Epithelial; Disease Models, Animal; Female; Humans; Neoplasm Staging; Neoplasms, Glandular and Epithelial; Omentum; Ovarian Neoplasms
PubMed: 24056004
DOI: 10.1016/j.ygyno.2013.09.014 -
Journal of Gastrointestinal Surgery :... Jun 2009The omentum is acknowledged to have diverse functions in the pathophysiology of intra-abdominal disease. Its angiogenic properties act as a natural defense mechanism in... (Review)
Review
INTRODUCTION
The omentum is acknowledged to have diverse functions in the pathophysiology of intra-abdominal disease. Its angiogenic properties act as a natural defense mechanism in peritonitis and intra-abdominal sepsis. With advancing technology the omentum is revealing itself as a new player in the field of molecular surgery with special reference to cancer, obesity and tissue reconstruction.
MATERIALS AND METHODS
This article reviews the existing and potential surgical applications of the omentum.
Topics: Bioreactors; Humans; Laparoscopy; Omentum; Plastic Surgery Procedures; Surgical Flaps; Tissue Engineering
PubMed: 19291335
DOI: 10.1007/s11605-009-0855-1 -
Current Medical Imaging 2022We report a case of a 23-year-old man with a solitary fibrous tumor of the great omentum who presented clinically as a case of dull abdominal pain. (Review)
Review
BACKGROUND
We report a case of a 23-year-old man with a solitary fibrous tumor of the great omentum who presented clinically as a case of dull abdominal pain.
CASE PRESENTATION
Solitary fibrous tumor normally occurs in the visceral pleura. Extrathoracic solitary fibrous tumor is rare, especially those from the great omentum, with approximately 31 cases reported in the literature.
CONCLUSION
After reviewing and summarizing the imaging findings of 31 cases of solitary fibrous tumor of the greater omentum, we considered that the characteristic findings can provide a reliable basis for preoperative diagnosis.
Topics: Adult; Humans; Male; Omentum; Solitary Fibrous Tumors; Young Adult
PubMed: 34749624
DOI: 10.2174/1573405617666211108111624 -
The International Journal of Artificial... Feb 2007
Review
Topics: Angiogenesis Inducing Agents; Humans; Male; Omentum; Regeneration; Wound Healing
PubMed: 17377903
DOI: 10.1177/039139880703000203 -
The Surgical Clinics of North America Feb 2000The significance of the greater omentum has been discovered recently by surgeons of various disciplines because it provides an excellent plastic material against... (Review)
Review
The significance of the greater omentum has been discovered recently by surgeons of various disciplines because it provides an excellent plastic material against inflammation and irradiation and for repair of defects that can be applied in the abdominal cavity; or it can be exteriorized and lengthened at a vascular pedicle and detached using microvascular anastomoses. Anatomic features, such as the volume of the omentum and the arrangement of the blood vessels, determine the lines of dissection. The eminent omental potential and the different biochemical and immunologic functions are unique, and can be related to specific anatomic structures, some of which may be drawn back to its embryologic sources. The ability of absorption and adhesion formation, neovascularization, and infection defense by the omentum protects against irradiation damage, accelerates healing of dead space, and improves the complication rate and quality of life after application to a wound bed.
Topics: Humans; Microsurgery; Omentum; Surgical Flaps
PubMed: 10685153
DOI: 10.1016/s0039-6109(05)70406-0