title: Internal hernia after laparoscopic gastric resection with antecolic Roux-en-Y reconstruction for gastric cancer.
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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Surgery, Jichi Medical University, Tochigi, Japan.
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Hosoya
authors.forename: Alan
authors.initials: A
authors.lastname: Lefor
authors.forename: Takashi
authors.initials: T
authors.lastname: Ui
authors.forename: Hidenori
authors.initials: H
authors.lastname: Haruta
authors.forename: Kentaro
authors.initials: K
authors.lastname: Kurashina
authors.forename: Shin
authors.initials: S
authors.lastname: Saito
authors.forename: Toru
authors.initials: T
authors.lastname: Zuiki
authors.forename: Naohiro
authors.initials: N
authors.lastname: Sata
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Yasuda
mesh_terms: D000713:Anastomosis, Roux-en-Y; D016009:Chi-Square Distribution; D005260:Female; D015390:Gastric Bypass; D046449:Hernia, Abdominal / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000601:surgery; D006801:Humans; D015994:Incidence; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000601:surgery*; D014057:Tomography, X-Ray Computed