What’s An Omentectomy?

A type of surgical procedure that operates on a thin, flat, layer of fatty tissue that blankets the abdominal organs, more specifically, the stomach and large intestine, among others. This tissue area is known as the omentum and contains the lymph nodes, lymph vessels, nerves, and blood vessels. Omentectomies are used to treat a few different cancers, including peritoneal mesothelioma, a type of cancer that develops in the tissue lining of the abdominal or peritoneal region. Other diseases that can be treated with an omentectomy are ovarian cancers that have spread to the omentum and fallopian tube cancer.

Cancer surgery is meant to remove as many visible tumors as possible. This is also known as debulking and can include removing pieces of the colon, bladder, stomach, liver, spleen, appendix, or pancreas. After the visible portions of the tumors are removed, other mesothelioma treatment methods may be employed to finish off the remaining cancer cells that are hard to get to. Treatments that could be used in conjunction with surgery include intraoperative or intraperitoneal chemotherapy, HIPEC, radiation, immunotherapy, and targeted therapies.

Am I a Candidate for Surgery?

If your doctor has given you a positive peritoneal mesothelioma diagnosis (or other abdominal cancer), you may be a candidate for surgery. After some tests, your doctor will assess if the omentectomy is curative (meant to eradicate or cure cancer). Or in the case where tumors have spread too far, palliative (meant to help ease the symptoms of the disease.) Your stage of mesothelioma and overall health will also help your doctor determine if you are the right candidate for surgery.

Some tests your doctor may administer a few weeks before surgery include:

  1. Blood and urine tests
  2. X-ray of the affected area
  3. Electrocardiogram (EKG, ECG) to check heart rhythm

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What to Expect with an Omentectomy

There are two types of omentectomy surgery. One is a supracolic omentectomy, also known as a total omentectomy that removes the entire omentum. Then there’s the partial omentectomy where a smaller, more specific area is targeted. The surgery is a laparoscopic procedure, meaning that it can be done by administering multiple small incisions, or traditionally, through one large incision in the abdomen.

Pre and Post Treatment Recommendations

There are multiple objectives to complete before a patient can undergo surgery. These recommendations are in place to ensure the operation goes as smoothly as possible. Firstly, make sure to keep your healthcare provider informed on prescribed medications, supplements, or herbal products you are taking beforehand. Also, make sure you do no eat or drink anything after midnight on the night before the procedure.

During the surgery, you may get something known as a peritoneal wash. This is where the surgeon injects a sterile fluid into your abdomen and then removes it. Sending this fluid back to a lab can help researchers determine more about unhealthy cells.

After the omentectomy, you may be required to stay in the medical center for 3 to 7 days. Recovery time will vary based on what other procedures you may have had in addition. There will be some pain, but your doctor can prescribe medicine to control it. If you’ve had some of your colon removed, you may be temporarily required to wear a colostomy bag. If part of the bladder is taken out, a thin tube called a catheter may be needed in the bladder to help remove urine until it begins to function correctly again.

Risks and Side-Effects of Treatment

Most risks and side-effects from an omentectomy are manageable. Make sure to keep your doctor up-to-date on any side-effects, especially if they begin to get out of control. Some risks and side-effects of surgery include:

  • Damage to nearby organs
  • Infection
  • Lymphedema (backup of fluid if lymph-vessels are blocked)
  • Nausea
  • Nerve damage that could be permanent
  • Some bleeding

The following symptoms are rarer and can indicate a more severe issue. Contact your doctor immediately if you experience:

  • Fever above 100.4 F
  • Redness, swelling, or liquid seeping from the incision site
  • Severe nausea, vomiting, or stomach pain
  • Heavy bleeding

Chance of Recurrence

Even after surgery and other treatments, tumors will always have a small chance of returning. When cancer can no longer be detected in the body, and there are no symptoms, it can be called having “no evidence of disease” or NED. A person can either be permanently or temporarily in the NED stage. After treatment, your doctor will administer more tests to assess your stage in illness and what the likelihood of recurrence is. These odds differ with each individual based on several variables, including genetics and type of cancer.

Talk With a Doctor

Your healthcare provider will be the final say in developing your specific cancer treatment plan. If you think an omentectomy could help you in treating your mesothelioma, ask your doctor for more details.

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