Abstract
PurposePetersen’s hernia (PH) is a serious complication after gastrectomy for gastric cancer. The aim of this study was to investigate whether closure of Petersen’s defect (PD) can decrease the rates of PH and suspected Petersen’s hernia (SPH).MethodsPatients who underwent gastrectomy with PD were enrolled. From January 2014 to January 2017, we performed gastrectomy without PD closure (non-closure group). From February 2017 to June 2018, we closed PDs during gastrectomy (closure group). The rates of PH and SPH were compared between the two groups. The last follow-up was updated in August 2020.ResultsAmong a total of 1213 patients, 12 patients (1.0%) developed PH, and 23 patients (1.9%) developed SPH. The rate of PH in the closure group was significantly lower than that in the non-closure group (1/385, 0.3% versus 11/828, 1.3%, p = 0.042, log-rank test). The rate of SPH in the closure group was significantly lower than that in the non-closure group (1/385, 0.3% versus 22/828, 2.7%, p = 0.008, log-rank test). Non-closure of PD was a risk factor for PH and SPH (odds ratio (OR) 7.72, 95% CI 1.84–32.35, p = 0.006).ConclusionsPD closure is recommended after gastrectomy for gastric cancer, as the rates of PH and SPH were significantly decreased.
Highlights
An internal hernia can lead to small bowel obstruction and life-threatening conditions, such as bowel ischemia or perforation [1, 2]
Some nonoperatively managed patients are highly suspicious for Petersen’s hernia (PH) according to manifestations and computed tomography (CT) scans [10, 11]; some of these patients might be misdiagnosed as having adhesive small bowel obstructions and managed non-operatively [12, 13]
There were no significant differences between the two groups with respect to sex, age, body mass index (BMI), previous abdominal surgery, surgical approach, reconstruction type, extent of lymphadenectomy, tumor diameter, tumor location, macroscopic type, tumor differentiation, TNM stage, or postoperative adjuvant chemotherapy
Summary
An internal hernia can lead to small bowel obstruction and life-threatening conditions, such as bowel ischemia or perforation [1, 2]. There have been few studies about internal hernia after gastrectomy for gastric cancer [1, 7], and to our. Some nonoperatively managed patients are highly suspicious for PH according to manifestations and computed tomography (CT) scans [10, 11]; some of these patients might be misdiagnosed as having adhesive small bowel obstructions and managed non-operatively [12, 13]. Patients with suspected Petersen’s hernia (SPH) may have nonspecific and recurrent abdominal pain; they are at risk of incarcerated internal hernia and bowel necrosis; great attention should be paid to these patients
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
