title: Omentoplasty in the prevention of anastomotic leakage after oesophagectomy: a meta-analysis.
abstract: OBJECTIVE
  To evaluate the efficacy of omentoplasty for the prevention of anastomotic leakage after oesophagectomy.
  
  
  METHODS
  A 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).
  
  
  RESULTS
  Three 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).
  
  
  CONCLUSIONS
  Omentoplasty may reduce the incidence of anastomotic leakage following oesophagectomy for oesophageal cancer.
authors.affiliation: Department of Thoracic Surgery, Nanjing Chest Hospital, 215 Guangzhou Road, Nanjing City, Jiangsu Province, China. Electronic address: chen2012liang@sina.cn.
authors.forename: L
authors.initials: L
authors.lastname: Chen
authors.affiliation: Department of Thoracic Surgery, Nanjing Chest Hospital, 215 Guangzhou Road, Nanjing City, Jiangsu Province, China. Electronic address: mtttfss@gmail.com.
authors.forename: F
authors.initials: F
authors.lastname: Liu
authors.affiliation: Department of Thoracic Surgery, Nanjing Chest Hospital, 215 Guangzhou Road, Nanjing City, Jiangsu Province, China.
authors.forename: K
authors.initials: K
authors.lastname: Wang
authors.affiliation: Department of Thoracic Surgery, Nanjing Chest Hospital, 215 Guangzhou Road, Nanjing City, Jiangsu Province, China.
authors.forename: W
authors.initials: W
authors.lastname: Zou
mesh_terms: D057868:Anastomotic Leak / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control*; D004938:Esophageal Neoplasms / Q000601:surgery*; D016629:Esophagectomy / Q000009:adverse effects*; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D007902:Length of Stay / Q000706:statistics & numerical data; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D009852:Omentum / Q000637:transplantation*; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
keywords: Anastomotic leakage; Meta-analysis; Oesophageal cancer; Omentoplasty