Pedicled Greater Omentum Flap Reinforcement Reduces Anastomotic Leakage and Improves Functional Recovery After Laparoscopic Sphincter-Preserving Surgery for Middle and Low rectal cancer Rectal Cancer: a Retrospective Comparative Study

Background The aim of this study is to determine whether reinforcement with a pedicled greater omentum flap is an effective measure for decreasing the incidence of Anastomotic leakage (AL) and low anterior resection syndrome (LARS). Methods The current retrospective comparative study collected patients with mid- and low-rectal cancer undergoing laparoscopic sphincter-preserving surgery between January 2023 and December 2024. The patients were divided into two groups: Group A was subjected to laparoscopic radical resection combined with reinforcement of the pelvic floor using a pedicled greater omentum flap, while Group B was subjected to the standard laparoscopic surgical procedure. The functional outcomes of the patients were recorded at 1, 3, 6, and 12 months using the LARS scoring system and the Wexner incontinence scoring system. Results Fifty-five patients were analyzed (Group A, n = 29; Group B, n = 26), with comparable baseline and perioperative characteristics. AL occurred in 1 patient (3.45%) in Group A (P < 0.05). LARS scores progressively improved in both groups; however, Group A showed significantly lower LARS scores at 1 and 3 months (P < 0.05). Similarly, Group A achieved better continence recovery, with lower Wexner scores at 6 months (P < 0.05). Conclusions The reinforcement of the pelvic floor using a pedicled greater omentum flap has been found to be a safe and feasible option during surgery for mid- and low-RC. The method significantly reduces the rate of AL and hastens recovery. The method has the potential to provide better outcomes for RC patients.