[A new use for the freely transplanted omentum. Management of a late radiation injury of the brachial plexus using freely transplanted omentum and neurolysis]

Abstract

A short review of the structural characteristics and the function of the greater omentum is presented. The results of treatment of secondary lymphedema by free transplantation of the omentum with microvascular anastomoses in the canine model and their relevance for clinical application are discussed. Clinical indications, operative technique, and results of omental transplantation and exoneurolysis of the brachial plexus in seven patients with constrictive, radiation induced brachial plexus paralysis, with and without secondary lymphedema, are reviewed. No effect of the grafted omentum on arm-lymphedema was observed over the entire observation period of 1 1/2--4 years. Minor degree reversion of neurodegenerative changes was found in two patients, in all other patients, these changes stopped. The most impressing result was the immediate and permanent disappearance of pain in all patients.