Impact of Omentectomy and Omentopexy on Catheter Outcomes in Continuous Ambulatory Peritoneal Dialysis: A Systematic Review and Meta-Analysis

Introduction: The role of omentectomy and omentopexy is crucial in reducing complications of catheter placement in peritoneal dialysis. This meta-analysis aimed to analyze the outcomes of omentectomy/omentopexy for patients undergoing peritoneal dialysis.Methods: Literature searching was done using PubMed, Cochrane Library, and Scopus, following the PRISMA guidelines. We used the keywords “continuous ambulatory peritoneal dialysis”, “omentectomy”, and “omentopexy” up to ۱st November ۲۰۲۴. Effect sizes for outcomes with continuous and binary data are mean difference (MD) and odds ratio (OR), respectively, with ۹۵% confidence interval. Outcomes include complications and surgical time. Results: Total of ۱۰ studies from ۳۸۱ articles were identified, consisting of retrospective and randomized controlled trial studies. From pooled analysis, omentectomy/omentopexy could reduce complications that lead to catheter removal (OR ۰.۳۱; ۹۵% CI: ۰.۲۲−۰.۴۴), catheter dysfunction (OR ۰.۱۶; ۹۵% CI: ۰.۰۳−۰.۸۴), and peritonitis (OR ۰.۲۸; ۹۵% CI: ۰.۱۴−۰.۵۶), but not significant for catheter leakage (OR ۰.۶; ۹۵% CI: ۰.۳۲−۱.۱۰) and bleeding (OR ۰.۴۴; ۹۵% CI: ۰.۰۹−۲.۱۴). We found no significant result for surgical time (MD ۱۲.۷۲ minutes; ۹۵% CI: -۳.۴۶−۲۸.۹۰).   Conclusion: This meta-analysis showed that omentectomy/omentopexy can reduce complications that lead to catheter removal, peritonitis, and catheter dysfunction. Further multicentre randomized controlled trials are essential to perform a thorough comparison between the omentectomy and omentopexy for both the pediatric and adult populations.

کلیدواژه ها:

omentectomy ، omentopexy ، peritoneal dialysis ، catheter outcomes