Autologous peritoneal patch for venous reconstruction: A systematic review of clinical outcomes

Venous reconstruction is increasingly required during complex abdominal and oncologic surgery. Autologous parietal peritoneum (PP) has emerged as a potential graft material due to its availability, biocompatibility, and low thrombogenic profile. This systematic review aimed to evaluate the safety and clinical outcomes of venous reconstruction using PP. A systematic search of MEDLINE (PubMed), ScienceDirect, Web of Science, and Embase was conducted from database inception to December 2025, in accordance with PRISMA guidelines. Studies reporting outcomes of venous reconstruction using PP were included. Data were extracted on patient characteristics, reconstruction site, technique, anticoagulation, imaging follow-up, and outcomes. The primary outcome was vascular complications (thrombosis and stenosis). Secondary outcomes included reintervention and 30-day mortality. Risk of bias was assessed using Joanna Briggs Institute tools. A narrative synthesis with pooled proportions was performed due to heterogeneity. Twenty studies, including 277 patients, were analyzed. The most common reconstruction sites were the inferior vena cava (45%), mesenterico-portal system (36%), and hepatic veins (19%). Patch repair was performed in 77% of cases. The pooled vascular complication rate was 15.1%, including thrombosis in 5.4% and stenosis in 8.3%. The pooled 30-day mortality rate was 1.4%. Follow-up ranged from 3 to 18 months, with variable anticoagulation and imaging protocols. Autologous PP is a feasible option for venous reconstruction with acceptable short-term outcomes. However, evidence is limited by heterogeneity and a lack of long-term data, warranting further prospective studies.