Comparison of Omental Patch Closure Versus Simple Closure for Laparoscopic Repair of Perforated Peptic Ulcer: A Systematic Review and Meta-Analysis

Aims To evaluate comparative outcomes of laparoscopic repair of perforated peptic ulcer with omental patch versus without omental patch. Methods A systematic search of multiple electronic data sources was conducted, and all studies comparing laparoscopic repair of perforated peptic ulcer (PPU) with...

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Bibliographic Details
Published in:The American Surgeon 2023-05, Vol.89 (5), p.2005-2013
Main Authors: Mohamedahmed, Ali Yasen y, Albendary, Mohamed, Patel, Kamlesh, Ayeni, Adewale Adeoba, Zaman, Shafquat, Zaman, Osama, Ibrahim, Rashid, Mobarak, Dham
Format: Article
Language:English
Subjects:
Abdomen
Bias
Clinical trials
Cohort analysis
Complications
Data analysis
Gender
Humans
Laparoscopy
Laparoscopy - adverse effects
Length of Stay
Meta-analysis
Mortality
Observational studies
Peptic Ulcer Perforation - complications
Peptic Ulcer Perforation - surgery
Peptic ulcers
Peritonitis
Postoperative
Postoperative Complications - etiology
Reoperation - adverse effects
Small intestine
Surgery
Systematic review
Treatment Outcome
Ulcers
Wound infection
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Summary:Aims To evaluate comparative outcomes of laparoscopic repair of perforated peptic ulcer with omental patch versus without omental patch. Methods A systematic search of multiple electronic data sources was conducted, and all studies comparing laparoscopic repair of perforated peptic ulcer (PPU) with and without omental patch were included. Operative time, postoperative complications, re-operation and mortality were the evaluated outcome parameters for the meta-analysis. Revman 5.3 was used for data analysis. Results Four observational studies reporting a total number of 438 patients who underwent laparoscopic repair of PPU with (n = 268) or without (n = 170) omental patch were included. Operative time was significantly shorter in no-omental patch group (NOP) when compared to omental patch group (P = .02). There was no significant difference in the risk of postoperative ileus (Odd ratio (OR) .76, P = .61), leakage (OR 1.17, P = .80), wound infection (OR 1.89, P = .34), intra-abdominal abscess (OR 1.17, P = .87), re-operation (OR .00, P = .94) and mortality (OR .55, P = .48). Moreover, length of hospital stay was comparable between the two groups (P = .81). Conclusion Laparoscopic repair of PPU with or without omental patch have comparable postoperative complications and mortality rate. However, considering the shorter operative time, no-omental patch approach is an attractive and more favourable choice. Well-designed randomized controlled trials are needed to investigate this comparison.
ISSN:0003-1348
1555-9823
DOI:10.1177/00031348211067991