Omentoplasty For The Prevention Of Anastomotic Leakage After Intestinal Resection

Background:Omentoplasty for the prevention of anastomotic leakage after intestinal resection was controversial,so an updated meta-analysis was conducted to assess the safety and effectiveness of omentoplasty for intestinal resection.Methods:Pubmed,Embase,and the Cochrane Library were searched from the inception to June 2017 for randomized controlled trials(RCTs),which explored omentoplasty for the prevention of anastomotic leakage after intestinal resection.Results:Four RCTs totaling 1067 patients(518 in omentoplasty group and 549 in no omentoplasty group)were included.Compared with no omentoplasty group,omentoplasty can effectively decrease the incidence of overall anastomotic leakage(4RCTs;RR:0.48;95%CI:0.27-0.87;P=0.02;I~2=38%),clinical anastomotic leakage(3 RCTs;RR=0.37;95%CI:0.17,0.83;P=0.02;I~2=0).Moreover,omentoplasty was associated with less length of hospitalization(1 RCT;MD=-6;95%CI:-7.43,-4.57;P<0.05).No significant difference can be found between the two groups in postoperative wound disruption,death,radiological anastomotic leakage,repeat operation,peritonitis,early wound abscess,anastomotic stricture,infection,extra-abdominal complications.Conclusion:Omentoplasty may be safe and effective to prevent anastomotic leakage after intestinal resection.Therefore,omentoplasty should be recommended in high-risk patients.