Omentoplasty Decreases Leak Rate After Esophagectomy: a Meta-analysis
To compare the efficacy of omentoplasty with non-omentoplasty in the prevention of postoperative anastomotic leakage, and to investigate the safety of omentoplasty.
Literature searches were performed of the Medline, EMBASE, and Cochrane Library databases. Studies that compared the efficacy of omentoplasty and non-omentoplasty after esophagectomy were selected. A meta-analysis was performed on anastomotic leakage, anastomotic stenosis, hospital mortality, and length of hospital stay. Results were reported as odds ratio (OR), weighted mean difference (WMD), or relative risk (RR), with 95% confidence intervals.
Six studies involving a total of 1608 patients met inclusion criteria. Compared with the non-omentoplasty group, the incidence of anastomotic leakage in the omentoplasty group (OR, 0.37; 95% CI, 0.23–0.60; P < 0.0001) was significantly reduced and the length of hospital stay (WMD, 2.13; 95% CI, 3.57–0.69; P = 0.004) was significantly shortened. However, there was no significant difference in the incidence of anastomotic strictures (OR, 0.82; 95% CI, 0.37–1.80; P = 0.61) or in-hospital mortality (OR, 0.61; 95% CI, 0.25–1.51; P = 0.29).
Omentoplasty after esophagectomy is a safe and effective method to prevent anastomotic leakage.
KeywordsOmentoplasty Esophagectomy Anastomotic leakage Meta-analysis
- 3.Junemann-Ramirez M, Awan MY, Khan ZM, Rahamim JS. Anastomotic leakage post-esophagogastrectomy for esophageal carcinoma: retrospective analysis of predictive factors, management and influence on longterm survival in a high volume centre. Eur J Cardiothorac Surg. 2005. 27(1): 3–7.CrossRefGoogle Scholar
- 5.Alanezi K, Urschel JD. Mortality secondary to esophageal anastomotic leak. Ann Thorac Cardiovasc Surg. 2004. 10(2): 71–5.Google Scholar
- 6.Peracchia A, Bardini R, Ruol A, Asolati M, Scibetta D. Esophagovisceral anastomotic leak. A prospective statistical study of predisposing factors. J Thorac Cardiovasc Surg. 1988. 95(4): 685–91.Google Scholar
- 9.Jesus EC, Karliczek A, Matos D, Castro AA, Atallah AN. Prophylactic anastomotic drainage for colorectal surgery. Cochrane Database Syst Rev. 2004. (4): CD002100.Google Scholar
- 18.Thakur B, Zhang CS, Tan ZB. Omentoplasty versus no omentoplasty for esophagogastrostomy after surgery for cancer of cardia and esophagus. Indian J Cancer. 2004. 41(4): 167–9.Google Scholar
- 23.Horstmann O, Verreet PR, Becker H, Ohmann C, Roher HD. Transhiatal oesophagectomy compared with transthoracic resection and systematic lymphadenectomy for the treatment of oesophageal cancer. Eur J Surg. 1995. 161(8): 557–67.Google Scholar