Omentoplasty in the prevention of anastomotic leakage after oesophagectomy: A meta-analysis |
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| Affiliation: | 1. Department of Molecular Medicine and Surgery, Karolinska Institutet and Center for Digestive Disease, Karolinska University Hospital, Solna, P9:03, 17176 Stockholm, Sweden;2. Karolinska Institutet (KI), Department of Oncology-Pathology (OnkPat) K7, Z4:01, Karolinska University Hospital, 17176 Stockholm, Sweden;3. Department of Radiology, Oncology and Radiation Science, Uppsala University, Akademiska sjukhuset, 75185 Uppsala, Sweden;1. Department of Radiation Oncology, Gustave Roussy, Université Paris Sud, Villejuif, France;2. Soft Tissue and Bone Sarcoma Multidisciplinary Unit, Gustave-Roussy, Villejuif, France;3. Department of Surgery, Gustave-Roussy, Villejuif, France;4. Department of Radiology, Gustave-Roussy, Villejuif, France;5. Plastic Surgery Unit, Gustave-Roussy, Villejuif, France;6. Department of Pathology, Gustave-Roussy, Villejuif, France;7. Department of Medical Oncology, Gustave-Roussy, Villejuif, France;1. Department of Urology, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, NY, USA;2. Department of Urology, University Hospital Basel, Basel, Switzerland;3. Department of Urology, Cochin Hospital, APHP, Paris Descartes University, Paris, France;4. Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany;5. Department of Urology, AP-HP, Hopital Pitié-Salpétrière, Service d''Urologie, Paris, France;6. UPMC Univ. Paris 06, GRC5, ONCOTYPE-Uro, Institut Universitaire de Cancérologie, Paris, France;7. Division of Urologic Surgery and Center for Surgery and Public Health, Brigham and Women''s Hospital/Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA;8. Department of Urology, Medical University of Vienna, Vienna, Austria;9. Department of Surgical, Oncological and Gastroenterologic Sciences, Urology Clinic, University of Padua, Italy;10. Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA;11. Department of Urology, Hospital Universitario Puerta de Hierro-Majadahonda, Universidad Autónoma de Madrid, Madrid, Spain;12. Department of Urology, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan;13. Department of Urology, Landesklinikum Korneuburg, Korneuburg, Austria;14. Department of Urology, University of Montreal, Montreal, QC, Canada;15. Department of Urology, Vita-Salute University, Milan, Italy;1. Division of Thoracic Surgery, Department of Surgery, China Medical University Hospital, Taichung, Taiwan;2. Division of General Surgery, Department of Surgery, China Medical University Hospital, Taichung, Taiwan;1. Department of Surgery, Sungkyunkwan University School of Medicine, South Korea;2. Center for Clinical Trial, National Cancer Center, South Korea;3. Center for Gastric Cancer, National Cancer Center, South Korea;4. Department of Surgery, Chonnam National University Hwasoon Hospital, South Korea |
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| Abstract: | ObjectiveTo evaluate the efficacy of omentoplasty for the prevention of anastomotic leakage after oesophagectomy.MethodsA systemic review of the Cochrane Library database CENTRAL, MEDLINE and EMBASE from inception to March 2014 was performed. Randomized controlled trials comparing omentoplasty with non-omentoplasty after oesophageal resection for a primary oncological indication were included. Meta-analysis was performed for anastomotic leakage, specific complication rates, in hospital mortality, local recurrence and duration of hospitalization. Data was reported as a Peto odds ratio (Peto OR), odds ratio (OR), weighted mean difference (WMD) or relative risk (RR) with 95% confidence intervals (CI).ResultsThree randomized controlled trials with a total of 633 anastamoses were included. The omentoplasty group demonstrated a significantly lower incidence of postoperative anastomotic leakage (Peto OR: 0.26; 95% CI 0.14 to 0.52), and reduced duration of hospitalization (WMD −2.13; 95% CI −3.57 to −0.69). There was no significant difference between the omentoplasty and non-omentoplasty groups in the incidence of anastomotic strictures (RR: 0.91, 95% CI: 0.33 to 2.57), hospital mortality (RR: 0.86, 95% CI: 0.29 to 2.51), pulmonary complications (RR: 0.90, 95% CI: 0.59 to 1.35) and recurrence after surgery (RR: 1.17, 95% CI: 0.95 to 1.43).ConclusionsOmentoplasty may reduce the incidence of anastomotic leakage following oesophagectomy for oesophageal cancer. |
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| Keywords: | Omentoplasty Oesophageal cancer Anastomotic leakage Meta-analysis |
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