Diagnosis and treatment of 27 cases of internal hernia after laparoscopic gastrectomy with Roux-en-Y reconstruction

doi:10.3877/cma.j.issn.1674-6899.2019.01.012

Abstract

Abstract:

Objective

To investigate clinical characteristics and management of internal hernia after laparoscopic gastrectomy.

Methods

The clinical data of 27 patients who underwent laparocopic gastrectomy for gastric cancer with Roux-en-Y reconstruction from Jan. 2010 to Jun. 2018 Northern Jiangsu Province Hospital, Clinical Medical College, Yangzhou University were retrospectively analyzed.

Results

Among the 27 patients with internal hernia, 25 patients underwent laparoscopic total gastrectomy with Roux-en-Y reconstruction, and 2 patients underwent laparoscopic distal gastrectomy with Roux-en-Y reconstruction. The main manifestations are severe pain in upper abdomen with nausea and vomiting. The time of onset was 6 days to 5 years after surgery, and 15 cases occurred within 1 year (55.6%). Among them, 23 patients received surgical treatment and 6 died, 4 patients received conservative treatment and 1 died. The total mortality rate was 25.93%.

Conclusions

Internal hernia is a rare and serious complication that is difficult to diagnose. It is necessary to close mesenteric defects to prevent abdominal hernia, during laparoscopic radical gastrectomy for Roux-en-Y anastomosis. Clinically, early surgical treatment is essential when it is suspected.

Key words: Laparoscopic, Gastric cancer, Roux-en-Y reconstruction, Internal hernia

Zhi Li, Liuhua Wang, Dong Tang, Wei Wang, Zhixiang Jin, Minghao Xu, Xiaoqing Wu, Qi Zhang, Daorong Wang. Diagnosis and treatment of 27 cases of internal hernia after laparoscopic gastrectomy with Roux-en-Y reconstruction[J]. Chinese Journal of Laparoscopic Surgery(Electronic Edition), 2019, 12(01): 62-64.

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