Background

Staple line reinforcement can be divided into 4 categories: Oversewing, gluing, buttressing, and omentopexy/gastropexy (OP/GP). The aim of this study is to compare the outcomes of sleeve gastrectomy (SG) with versus without OP/GP.

Methods

Literature search was done according to the PRISMA guidelines. Meta-analysis was done using the RevMen 5.4.1 software. Statistical method used was Mantel-Haenszel. Analysis model used was random effects regardless of the heterogeneity (I2).

Results

Meta-analysis of randomized controlled trials comparing between SG with versus without OP/GP revealed statistically significant decrease in denovo GERD (OR 0.33, CI 0.15, 0.73) and gastric twist (OR 0.18, CI 0.04, 0.85), and increase in operative time (MD 7.29, CI 2.20, 12.37). In addition, analysis revealed statistically insignificant decrease in leaks (OR 0.37, CI 0.10, 1.42), postoperative bleeding (OR 0.32, CI 0.10, 1.03), readmissions (OR 0.91, CI 0.04, 18.48), and total weight loss % at 1 year (MD -0.43, CI -1.59, 0.74), and statistically insignificant increase in length of stay (MD 0.06, CI -0.16, 0.29).

Conclusions

OP/GP decreases the risks of gastric twist and denovo GERD following SG. The significant decrease in denovo GERD is a very important finding, and more studies are warranted to confirm this. Although insignificant, the decreases in postoperative bleeding and leaks were very close to the significance cutoff, studies with larger sample size might prove that these decreases are statistically significant.