The mesenteric defects in laparoscopic Roux-en-Y gastric bypass: 5 years follow-up of non-closure versus closure using the stapler techniqueReport as inadecuate




The mesenteric defects in laparoscopic Roux-en-Y gastric bypass: 5 years follow-up of non-closure versus closure using the stapler technique - Download this document for free, or read online. Document in PDF available to download.

Surgical Endoscopy

pp 1–6

First Online: 15 February 2017Received: 12 November 2016Accepted: 08 January 2017

Abstract

Background Internal hernia IH is a common complication of laparoscopic Roux-en-Y gastric bypass LRYGB. Little large-volume data exist on how to handle the mesenteric defects during LRYGB. This study evaluated long-term follow-up 5.5 years of 2443 patients with primary closure of the mesenteric defects with a stapling device at LRYGB, in comparison with a non-closed group from the same centre.

Methods All patients N = 4013 undergoing LRYGB over a 10-year period 2005–2015 at a single institution were evaluated. The mesenteric defects were routinely closed starting June 2010. In total, 1570 non-closure patients and 2443 patients with stapled closure of the defects were prospectively entered and the results analysed.

Results Closure of the mesenteric defects increased surgical time by 4 min and did not affect the 30-day complication rate. IH incidence was significantly lower 2.5% in the closure group compared with 11.7% in the non-closure group, at 60 months. The relative risk reduction by closing the mesenteric defects was 4.09-fold 95% CI = 2.97–5.62 as calculated using a survival model.

Conclusions Internal hernia after LRYGB occurs frequently if mesenteric defects are left unclosed. Primary closure with a hernia-stapling device is safe and significantly reduces the risk of internal hernia.

KeywordsBariatric surgery Laparoscopic Roux-en-Y gastric bypass Internal hernia Mesenteric defects closure Complication Peterson Electronic supplementary materialThe online version of this article doi:10.1007-s00464-017-5415-2 contains supplementary material, which is available to authorized users.

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Author: Ebrahim Aghajani - Bent J. Nergaard - Bjorn G. Leifson - Jan Hedenbro - Hjortur Gislason

Source: https://link.springer.com/article/10.1007/s00464-017-5415-2



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