Abstract
Background : The aim of this study was to describe the occurrence and clinical characteristics of symptomatic internal hernias after gastrectomy and antecolic Roux-en-Y reconstructions for gastric carcinoma.
Methods : This study retrospectively reviewed 290 cases performed total or distal gastrectomy with RY reconstruction via laparotomy or laparoscopy at our hospital between 2006 and August 2011.
Results ; Internal hernias were identified in a total of eight cases (2.8%) of the 290 cases, with two (1.5%) cases following gastrectomy via laparotomy and six (3.8%) cases following laparoscopic gastrectomy. Although a higher incidence of internal hernias was noted with laparoscopic gastrectomy, no statistically significant difference was observed (p = 0.237). With regard to total gastrectomy, internal hernias occurred in five of 77 (6.5%) laparoscopic total gastrectomy cases and a significant difference (p = 0.013) was observed between the total gastrectomy via laparotomic and laparoscopic total gastrectomy groups. These internal hernias included those at the Petersen's space in five cases and those at mesojejunal space in the remaing three cases.
Concluson ; There is a high risk of internal hernia with laparoscopic antecolic RY reconstruction following curative resection for gastric carcinoma. Closure of the Petersen's and mesojejunal spaces is important for antecolic reconstruction, regardless of mesenteric treatment of the ascending jejunum.
