Internal Hernia After Laparoscopic Total Gastrectomy for Gastric Cancer. Issue 6 (December 2017)

• Record Type: Journal Article
• Authors: Ojima, Toshiyasu; Nakamori, Mikihito; Nakamura, Masaki; Katsuda, Masahiro; Hayata, Keiji; Kato, Tomoya; Tsuji, Toshiaki; Yamaue, Hiroki
• Is Part Of: Surgical laparoscopy endoscopy & percutaneous techniques. Volume 27:Issue 6(2017)
• Publication Date: 2017-12
• Subjects: laparoscopic gastrectomy -- internal hernia -- closure of mesenteric defects -- gastric cancer; Endoscopic surgery -- Periodicals; Laparoscopic surgery -- Periodicals; Endoscopy -- Periodicals; Laparoscopy -- Periodicals; 617.550597
• DOI: 10.1097/SLE.0000000000000481
• Languages: English
• ISSNs: 1530-4515

Abstract

Abstract : Purpose: The aim of this study was to clarify internal hernia (IH) characteristics after laparoscopic gastrectomy. Materials and Methods: This was a retrospective study of 1943 consecutive gastric cancer patients who underwent surgery at our institute between 2004 and 2015. Since 2013, our technique includes antecolic Roux-en-Y (RY) with closure of all mesenteric defects during laparoscopic total gastrectomy (LTG) as standard. Results: Postoperative IH was only detected in patients who underwent total gastrectomy with RY reconstruction. Furthermore, the incidence of IH was significantly higher after LTG than after open total gastrectomy (4.9% vs. 1.0%; P =0.005). IH after LTG occurred in 8.0% of patients before standardization with closure of the mesenteric defects, but no IH was observed after standardization ( P =0.047). Conclusions: Closure of all mesenteric defects is recommended for gastric cancer patients who undergo LTG with antecolic RY. Registration number: UMIN000009163/000025029 (www.umin.ac.jp/ctr/ )