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01-04-2012

Recent Trend of Internal Hernia Occurrence After Gastrectomy for Gastric Cancer

Authors: Hiromichi Miyagaki, Shuji Takiguchi, Yukinori Kurokawa, Motohiro Hirao, Shigeyuki Tamura, Toshirou Nishida, Yutaka Kimura, Yoshiyuki Fujiwara, Masaki Mori, Yuichiro Doki

Published in: World Journal of Surgery | Issue 4/2012

Abstract

Background

The incidence of internal hernia after gastrectomy can increase with the increasing use of laparoscopic surgery, although this trend has not been elucidated.

Methods

Clinical information was collected from medical records and by questionnaire for 18 patients who underwent surgical treatment for internal hernia after gastrectomy for gastric cancer in 24 hospitals from January 2005 to December 2009.

Results

Gastrectomy for gastric cancer was open/distal gastrectomy (DG) in five (28%) patients, open/total gastrectomy (TG) in seven (39%), laparoscopy-assisted/DG in three (17%), and laparoscopy-assisted/TG in 3 (17%). Reconstruction was by Roux-Y methods in all patients. The hernia orifice was classified as a jejunojejunostomy mesenteric defect in eight patients (44%), dorsum of the Roux limb (Petersen’s space) in eight (44%), and one (5%) each of esophageal hiatus and mesenterium of the transverse colon. Among 8,983 patients who underwent gastrectomy for gastric cancer, a postoperative survey revealed that 13 patients underwent surgical treatment for internal hernia in the same hospitals. The 3-year incidence rate of the internal hernia was 0.19%, which was significantly higher after laparoscopy-assisted than open gastrectomy (0.53 vs. 0.15%, p = 0.03). Patients with an internal hernia had a mean (±SD) low weight at hernia operation (body mass index 17.9 ± 1.6 kg/m²) and marked weight loss after gastrectomy (weight reduction 15.6 ± 5.8%).

Conclusions

Gastrectomy with Roux-Y reconstruction for gastric cancer leaves several spaces that can cause internal hernia formation. Laparoscopic surgery and postoperative body weight loss are potential risk factors.

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Title: Recent Trend of Internal Hernia Occurrence After Gastrectomy for Gastric Cancer
Authors: Hiromichi Miyagaki
Shuji Takiguchi
Yukinori Kurokawa
Motohiro Hirao
Shigeyuki Tamura
Toshirou Nishida
Yutaka Kimura
Yoshiyuki Fujiwara
Masaki Mori
Yuichiro Doki
Publication date: 01-04-2012
Publisher: Springer-Verlag
Published in: World Journal of Surgery / Issue 4/2012
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-012-1479-2

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Recent Trend of Internal Hernia Occurrence After Gastrectomy for Gastric Cancer

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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