Zarzycki Piotr, Kulawik Jan, Małczak Piotr, Rubinkiewicz Mateusz, Wierdak Mateusz, Major Piotr
2nd Department of General Surgery, Jagiellonian University Medical College, Jakubowskiego 2 st., 30-688, Krakow, Poland.
Obes Surg. 2021 Jun;31(6):2709-2716. doi: 10.1007/s11695-021-05327-8. Epub 2021 Mar 6.
Laparoscopic sleeve gastrectomy (LSG) is one of the most commonly performed bariatric procedure worldwide. Omentopexy during LSG is a novel variation of this well-established technique. There are no clear conclusions on indications for this procedure, safeness, and effects of such a method. We aimed to compare the outcomes of laparoscopic sleeve gastrectomy (LSG) with omentopexy (OP) and without omentopexy.
We searched the Medline, EMBASE, and Scopus databases up-to June 2020. Full-text articles and conference abstracts were included for further analysis. This review follows the PRISMA guidelines.
Of initial 66 records, only 4 studies (N = 1396 patients) were included in the meta-analysis. Our findings showed that LSG with omentopexy had significantly lowered overall morbidity compared to LSG without omentopexy (RR = 0.38; 95% CI [0.15, 0.94]; p=0.04). Gastric leakage rate (RR = 0.17; 95% CI [0.04, 0.76]; p = 0.02) was also significantly lower in LSG with omentopexy. There were no significant differences between groups in length of hospital stay.
Our meta-analysis showed that LSG with omentopexy may be a feasible procedure for decreasing morbidity and gastric leak rate. However, despite promising results, the procedure needs to be researched more in randomized controlled studies to draw solid conclusions.
腹腔镜袖状胃切除术（LSG）是全球最常施行的减肥手术之一。LSG术中大网膜固定术是这一成熟技术的一种新变体。对于该手术的适应症、安全性及此方法的效果尚无明确结论。我们旨在比较有大网膜固定术（OP）和无大网膜固定术的腹腔镜袖状胃切除术（LSG）的手术效果。
我们检索了截至2020年6月的Medline、EMBASE和Scopus数据库。纳入全文文章和会议摘要以进行进一步分析。本综述遵循PRISMA指南。
在最初的66条记录中，只有4项研究（N = 1396例患者）被纳入荟萃分析。我们的研究结果表明，与无大网膜固定术的LSG相比，有大网膜固定术的LSG总体发病率显著降低（RR = 0.38；95%CI [0.15, 0.94]；p = 0.04）。有大网膜固定术的LSG胃漏率（RR = 0.17；95%CI [0.04, 0.76]；p = 0.02）也显著更低。两组之间住院时间无显著差异。
我们的荟萃分析表明，有大网膜固定术的LSG可能是一种降低发病率和胃漏率的可行手术。然而，尽管结果令人鼓舞，但该手术仍需在随机对照研究中进行更多研究以得出确凿结论。
