ABSTRACT
This chapter provides a short historical survey of the greater omentum from a cultural and surgical perspective; its macroscopic and microscopic anatomy will be reviewed in relation to its procancerous features. It discusses the incidence of omental metastases and the role of omentectomy in cytoreductive surgery. In extensive peritoneal carcinomatosis, the greater omentum is almost invariably involved in virtually every malignancy giving rise to peritoneal surface disease. Whereas ovarian cancer generally tends to respond well to intravenous chemotherapy, the response of colorectal carcinomatosis to systemic treatment is usually poor. The greater omentum is a double-layered leaf of the peritoneum, attached to the greater curvature of the stomach as well as the transverse colon. Although it generally consists of fat, the omentum is commonly involved in peritoneal carcinomatosis in virtually every peritoneal surface malignancy. In case of gross involvement of the greater omentum seen during cytoreductive surgery, omentectomy is obviously indicated.
