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Internal hernia after laparoscopic gastric resection with antecolic Roux-en-Y reconstruction for gastric cancer

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Abstract

Background

To decrease the incidence of internal hernia after laparoscopic gastric bypass, current recommendations include closure of mesenteric defects. Laparoscopic gastric resection is used increasingly for the treatment of gastric cancer, but the incidence of internal hernia in the treated patients has not been studied.

Methods

This study retrospectively reviewed 173 patients who underwent laparoscopic resection for gastric cancer at one institution, including distal and total gastric resections with antecolic Roux-en-Y reconstruction.

Results

An internal hernia occurred in 4 (7%) of 58 patients whose jejunojejunal mesenteric defect was not closed a mean of 326 days after surgery. All the patients underwent reoperation with reduction and repair of the hernia. In 115 subsequent cases, with closure of the mesenteric defect, internal hernias did not occur (0/115 cases; p < 0.05).

Conclusion

Based on the current recommendations for patients undergoing bariatric surgery, closure of this potential hernia defect is mandatory after laparoscopic gastrectomy with a Roux-en-Y reconstruction for gastric cancer.

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Disclosures

Drs. Yoshinori Hosoya, Alan Lefor, Takashi Ui, Hidenori Haruta, Kentaro Kurashina, Shin Saito, Toru Zuiki, Naohiro Sata, and Yoshikazu Yasuda have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Department of Surgery, Jichi Medical University, 3311-1 Shimotsuke, Tochigi, 329-0498, Japan

    Yoshinori Hosoya, Alan Lefor, Takashi Ui, Hidenori Haruta, Kentaro Kurashina, Shin Saito, Toru Zuiki, Naohiro Sata & Yoshikazu Yasuda

Authors
  1. Yoshinori Hosoya
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  2. Alan Lefor
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  3. Takashi Ui
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  4. Hidenori Haruta
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  5. Kentaro Kurashina
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  6. Shin Saito
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  7. Toru Zuiki
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  8. Naohiro Sata
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  9. Yoshikazu Yasuda
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Corresponding author

Correspondence to Alan Lefor.

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Hosoya, Y., Lefor, A., Ui, T. et al. Internal hernia after laparoscopic gastric resection with antecolic Roux-en-Y reconstruction for gastric cancer. Surg Endosc 25, 3400–3404 (2011). https://doi.org/10.1007/s00464-011-1739-5

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  • DOI: https://doi.org/10.1007/s00464-011-1739-5

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