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Internal hernia after gastrectomy for gastric cancer in minimally invasive surgery era

BACKGROUND: The incidence and clinical presentation of internal hernia after gastrectomy have been changing in the minimally invasive surgery era. This study aimed to analyze the clinical features and risk factors for internal hernia after gastrectomy for gastric cancer. METHODS: We retrospectively...

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Autores principales: Kang, Kyong Min, Cho, Yo Seok, Min, Sa-Hong, Lee, Yoontaek, Park, Ki Bum, Park, Young Suk, Ahn, Sang-Hoon, Park, Do Joong, Kim, Hyung-Ho
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Nature Singapore 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6694080/
https://www.ncbi.nlm.nih.gov/pubmed/30758761
http://dx.doi.org/10.1007/s10120-019-00931-1
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author Kang, Kyong Min
Cho, Yo Seok
Min, Sa-Hong
Lee, Yoontaek
Park, Ki Bum
Park, Young Suk
Ahn, Sang-Hoon
Park, Do Joong
Kim, Hyung-Ho
author_facet Kang, Kyong Min
Cho, Yo Seok
Min, Sa-Hong
Lee, Yoontaek
Park, Ki Bum
Park, Young Suk
Ahn, Sang-Hoon
Park, Do Joong
Kim, Hyung-Ho
author_sort Kang, Kyong Min
collection PubMed
description BACKGROUND: The incidence and clinical presentation of internal hernia after gastrectomy have been changing in the minimally invasive surgery era. This study aimed to analyze the clinical features and risk factors for internal hernia after gastrectomy for gastric cancer. METHODS: We retrospectively analyzed internal hernia after gastrectomy for gastric cancer in 6474 patients between January 2003 and December 2016 at Seoul National University Bundang Hospital. Multivariable logistic regression was performed to evaluate risk factors. RESULTS: Internal hernias identified by computed tomography or surgical exploration were 111/6474 (1.7%) and the median interval time was 450 days after gastrectomy. Fourteen (0.9%) of the 1510 patients who underwent open gastrectomy and 97 (2.0%) of the 4964 patients who underwent laparoscopic gastrectomy developed internal hernia. Of the 6474 patients, internal hernia developed in 0 (0%), 9 (1.1%), 40 (3.1%), 56 (3.3%), 6 (2.3%), and 0 (0%) patients who underwent Billroth I, Billroth II, Roux-en-Y, uncut Roux-en-Y, double tract, and esophagogastrostomy reconstructions, respectively. Fifty-nine (53.2%) of 111 patients with symptomatic hernia underwent surgery. Of the 59 internal hernias, treated surgically, 32 (53.2%), 27 (45.8%), and 0 (0%) were identified in jejunojejunostomy mesenteric, Petersen’s, and transverse colon mesenteric defects, respectively. In multivariate analysis, non-closure of mesenteric defects (P < 0.01), laparoscopic approach (P < 0.01), and totally laparoscopic approach (P = 0.03) were independent risk factors for internal hernia. CONCLUSIONS: The potential spaces such as Petersen’s, jejunojejunostomy mesenteric, and transverse colon mesenteric defects should be closed to prevent internal hernia after gastrectomy for gastric cancer.
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spelling pubmed-66940802019-08-28 Internal hernia after gastrectomy for gastric cancer in minimally invasive surgery era Kang, Kyong Min Cho, Yo Seok Min, Sa-Hong Lee, Yoontaek Park, Ki Bum Park, Young Suk Ahn, Sang-Hoon Park, Do Joong Kim, Hyung-Ho Gastric Cancer Original Article BACKGROUND: The incidence and clinical presentation of internal hernia after gastrectomy have been changing in the minimally invasive surgery era. This study aimed to analyze the clinical features and risk factors for internal hernia after gastrectomy for gastric cancer. METHODS: We retrospectively analyzed internal hernia after gastrectomy for gastric cancer in 6474 patients between January 2003 and December 2016 at Seoul National University Bundang Hospital. Multivariable logistic regression was performed to evaluate risk factors. RESULTS: Internal hernias identified by computed tomography or surgical exploration were 111/6474 (1.7%) and the median interval time was 450 days after gastrectomy. Fourteen (0.9%) of the 1510 patients who underwent open gastrectomy and 97 (2.0%) of the 4964 patients who underwent laparoscopic gastrectomy developed internal hernia. Of the 6474 patients, internal hernia developed in 0 (0%), 9 (1.1%), 40 (3.1%), 56 (3.3%), 6 (2.3%), and 0 (0%) patients who underwent Billroth I, Billroth II, Roux-en-Y, uncut Roux-en-Y, double tract, and esophagogastrostomy reconstructions, respectively. Fifty-nine (53.2%) of 111 patients with symptomatic hernia underwent surgery. Of the 59 internal hernias, treated surgically, 32 (53.2%), 27 (45.8%), and 0 (0%) were identified in jejunojejunostomy mesenteric, Petersen’s, and transverse colon mesenteric defects, respectively. In multivariate analysis, non-closure of mesenteric defects (P < 0.01), laparoscopic approach (P < 0.01), and totally laparoscopic approach (P = 0.03) were independent risk factors for internal hernia. CONCLUSIONS: The potential spaces such as Petersen’s, jejunojejunostomy mesenteric, and transverse colon mesenteric defects should be closed to prevent internal hernia after gastrectomy for gastric cancer. Springer Nature Singapore 2019-02-13 2019 /pmc/articles/PMC6694080/ /pubmed/30758761 http://dx.doi.org/10.1007/s10120-019-00931-1 Text en © The Author(s) 2019 https://creativecommons.org/licenses/by/4.0/ Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Original Article
Kang, Kyong Min
Cho, Yo Seok
Min, Sa-Hong
Lee, Yoontaek
Park, Ki Bum
Park, Young Suk
Ahn, Sang-Hoon
Park, Do Joong
Kim, Hyung-Ho
Internal hernia after gastrectomy for gastric cancer in minimally invasive surgery era
title Internal hernia after gastrectomy for gastric cancer in minimally invasive surgery era
title_full Internal hernia after gastrectomy for gastric cancer in minimally invasive surgery era
title_fullStr Internal hernia after gastrectomy for gastric cancer in minimally invasive surgery era
title_full_unstemmed Internal hernia after gastrectomy for gastric cancer in minimally invasive surgery era
title_short Internal hernia after gastrectomy for gastric cancer in minimally invasive surgery era
title_sort internal hernia after gastrectomy for gastric cancer in minimally invasive surgery era
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6694080/
https://www.ncbi.nlm.nih.gov/pubmed/30758761
http://dx.doi.org/10.1007/s10120-019-00931-1
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