Mesenteric closure after laparoscopic total gastrectomy with Roux-en-Y reconstruction is effective for prevention of internal hernia: a multicenter retrospective study
- 27.09.2021
Erschienen in:
- Verfasst von
- Katsuhiro Murakami
- Kazutaka Obama
- Seiichiro Kanaya
- Seiji Satoh
- Dai Manaka
- Michihiro Yamamoto
- Yoshio Kadokawa
- Atsushi Itami
- Hiroshi Okabe
- Hiroaki Hata
- Eiji Tanaka
- Yoshito Yamashita
- Masato Kondo
- Hisahiro Hosogi
- Shigeru Tsunoda
- Shigeo Hisamori
- Tatsuto Nishigori
- Yoshiharu Sakai
- Erschienen in
- Surgical Endoscopy | Ausgabe 6/2022
Abstract
Background
Internal hernia (IH) is one of the critical complications after gastrectomy with Roux-en-Y reconstruction, which can be prevented by closing mesenteric defects. However, only few studies have investigated the incidence of IH after laparoscopic total gastrectomy (LTG) with Roux-en-Y reconstruction for gastric cancer till date. This study aimed to assess the efficacy of defect closure for the prevention of IH after LTG.
Methods
This multicenter, retrospective cohort study collected data from 714 gastric cancer patients who underwent LTG with Rou-en-Y reconstruction between 2010 and 2016 in 13 hospitals. We evaluated the incidence of postoperative IH by comparing closure and non-closure groups of Petersen’s defect, jejunojejunostomy mesenteric defect, and transverse mesenteric defect.
Results
The closure group for Petersen’s defect included 609 cases, while the non-closure group included 105 cases. The incidence of postoperative IH in the closure group for Petersen’s defect was significantly lower than it was in the non-closure group (0.5% vs. 4.8%, p < 0.001). The closure group for jejunojejunostomy mesenteric defect included 641 cases, while the non-closure group included 73 cases. The incidence of postoperative IH in the closure group of jejunojejunostomy mesenteric defect was significantly lower than that in the non-closure group (0.8% vs. 4.1%, p = 0.004). Out of 714 patients, 41 underwent retro-colic reconstruction. No patients in the transverse mesenteric defect group developed IH.
Conclusion
Mesenteric defect closure after LTG with Roux-en-Y reconstruction may reduce postoperative IH incidence. Endoscopic surgeons should take great care to prevent IH by closing mesenteric defects.
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- Titel
- Mesenteric closure after laparoscopic total gastrectomy with Roux-en-Y reconstruction is effective for prevention of internal hernia: a multicenter retrospective study
- Verfasst von
-
Katsuhiro Murakami
Kazutaka Obama
Seiichiro Kanaya
Seiji Satoh
Dai Manaka
Michihiro Yamamoto
Yoshio Kadokawa
Atsushi Itami
Hiroshi Okabe
Hiroaki Hata
Eiji Tanaka
Yoshito Yamashita
Masato Kondo
Hisahiro Hosogi
Shigeru Tsunoda
Shigeo Hisamori
Tatsuto Nishigori
Yoshiharu Sakai
- Publikationsdatum
- 27.09.2021
- Verlag
- Springer US
- Erschienen in
-
Surgical Endoscopy / Ausgabe 6/2022
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218 - DOI
- https://doi.org/10.1007/s00464-021-08744-z
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