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. 2021 Dec 24:8:708545.
doi: 10.3389/fsurg.2021.708545. eCollection 2021.

Comparison of Survival and Safety Between Total Omentectomy and Partial Omentectomy for Gastric Cancer: A Meta-Analysis

Yue-Xin Zhang  1   2 , Han-Dong Liu  3 , Ze-Hua Chen  1   2 , Tao Jin  1   2 , Jian-Kun Hu  1   2 , Kun Yang  1   2
Affiliations

Comparison of Survival and Safety Between Total Omentectomy and Partial Omentectomy for Gastric Cancer: A Meta-Analysis

Yue-Xin Zhang et al. Front Surg. .

Abstract

Background: The greater omentum can limit abdominal inflammation and act as a protective cushion, but it is always involved in dissemination of gastric cancer. The purpose of this meta-analysis was to compare the survival and safety between total omentectomy and partial omentectomy for gastric cancer. Methods: Two investigators independently conducted a systematic search of PubMed, Embase, CNKI, and Cochrane Library ranging from January 2000 to November 2020. The pooled odds ratio (ORs) and weighted mean difference (WMD) with the 95% confidence interval (95% CI) were used to assess perioperative and survival parameters. Results: A total of 2,031 patients in 11 studies (574 patients in the partial omentectomy group and 1,457 patients in the total omentectomy group) were included. The results found shorter operation time (WMD = -25.584; P = 0.000) and less intraoperative blood loss (WMD = -47.301; P = 0.050) in the partial omentectomy group, compared to total omentectomy. There were no significant differences in terms of incidence of complications (OR = 0.770; P = 0.164), blood transfusions rates (OR = 0.269; P = 0.161), time to first flatus (WMD = 0.160; P = 0.345), hospital stay (WMD = -1.258; P = 0.087), and number of harvested lymph nodes (WMD = 1.265; P = 0.662). For the disease-free survival (OR = 0.80; P = 0.381) and overall survival, there were no statistical differences between the two procedures. Conclusions: The partial omentectomy could reduce operation time and trended to decrease intraoperative blood loss. And the survival in patients with partial omentectomy seemed to be comparable to that of patients with total omentectomy.

Keywords: gastric cancer; partial omentectomy; safety; survival; total omentectomy.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow chart for study selection.
Figure 2
Figure 2
Forest plots[(A) Complications, (B) The number of retrieved lymph nodes, (C) Intraoperative blood loss, (D) Time to first flatus, (E) Operation time, (F) Postoperative hospital stay, (G) Blood Infusion, (H) Comparison of operation time in open surgery].
Figure 3
Figure 3
(A) Sensitivity analysis on the operation time, (B) The funnel plot on the complications.
See this image and copyright information in PMC

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