The effect of omentoplasty in various surgical operations: Systematic review and meta-analysis

Abstract

Background: Omentoplasty is commonly used in various surgeries. However, its effectiveness is unsure due to lack of convincing data and research. To clarify the impact of omentoplasty on postoperative complications of various procedures, this systematic review and meta-analysis was performed. Methods: A systematic review of published literatures from four databases: PubMed, Web of Science, Cochrane Library, and Embase before July 14, 2022. We primarily included publications on five major surgical operations performed in conjunction with omentoplasty: thoracic surgery, esophageal surgery, gastrointestinal surgery, pelvi-perineal surgery, and liver surgery. The protocol was registered in PROSPERO. Results: This review included 25 273 patients from 91 studies (n=9 670 underwent omentoplasty). Omentoplasty was associated with a lower risk of overall complications particularly in gastrointestinal (RR 0.53; 95%CI 0.39-0.72) and liver surgery (RR 0.54; 95%CI 0.39-0.74). Omentoplasty reduced the risk of postoperative infection in thoracic (RR 0.38; 95%CI 0.18-0.78) and liver surgery (RR 0.39; 95%CI 0.29-0.52). In patients undergoing esophageal (RR 0.89; 95%CI 0.80-0.99) and gastrointestinal (RR 0.28; 95%CI 0.23-0.34) surgery with a BMI greater than 25, omentoplasty is significantly associated with a reduced risk of overall complications compared to patients with normal BMI. No significant differences were found in pelvi-perineal surgery, except infection in patients whose BMI ranged from 25 kg/m2 to 29.9 kg/m2 (RR 1.25; 95%CI 1.04-1.50) and anastomotic leakage in patients aged over 60 (RR 0.59; 95%CI-0.39-0.91). Conclusion: Omentoplasty can effectively prevent postoperative infection. It is associated with a lower incidence of multiple postoperative complications in gastrointestinal and liver surgery.