J.Jpn. Surg. Soc.. 79(8): 677-681, 1978

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Report on the annual meeting

OMENTAL TRANSPLANTATION FOR BUERGER'S DISEASE

A new surgical procedure was employed for relieving severe ischemia of the legs with extensive arterial obliterations distal to the popliteal trifurcation in 24 patients suffering from thromboangitis obliterans. The omentum was resected with the gastro-epiploic and omental arterial arcades, and transplanted into intermuscular spaces of the extremity, anastomosing the graft vessels to the femoral vessels.
The results were extremely encouraging, when examined up to six years postoperatively. Claudication disappeared in 14 out of 19 (73.7%). Rest pains were remarkably improved in 15 out of 16 (94%).
Eight out of 10 patients with the ulcer (80%) had complete healing within 3 post-op. months without recurrens.
These improvements were well substantiated by angiography, thermography and plethysomgraphy etc. The maximal blood-flow during excercise (mean MBFe: 31.1 ml/100 g/min) calculated from ¹³³Xe clearance curves in the anterior tibial muscles of the 5 limbs on which the omental transplantation has been performed was significantly higher compared to the flow before operation (22.2 ml/100 g/min).
Based on these clinical studies the rationale for this treatment is regarded as “biological bypass revascularization” augumented through arteriolar nets of the implated omentum.

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