Title |
The mesenteric defects in laparoscopic Roux-en-Y gastric bypass: 5 years follow-up of non-closure versus closure using the stapler technique
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Published in |
Surgical Endoscopy, February 2017
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DOI | 10.1007/s00464-017-5415-2 |
Pubmed ID | |
Authors |
Ebrahim Aghajani, Bent J. Nergaard, Bjorn G. Leifson, Jan Hedenbro, Hjortur Gislason |
Abstract |
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. 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. 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. 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. |
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United States | 2 | 25% |
Australia | 1 | 13% |
United Kingdom | 1 | 13% |
Unknown | 4 | 50% |
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Scientists | 2 | 25% |
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Mendeley readers
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Switzerland | 1 | 2% |
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Student > Master | 8 | 14% |
Student > Ph. D. Student | 6 | 11% |
Researcher | 5 | 9% |
Student > Postgraduate | 5 | 9% |
Student > Doctoral Student | 4 | 7% |
Other | 12 | 21% |
Unknown | 16 | 29% |
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Nursing and Health Professions | 4 | 7% |
Pharmacology, Toxicology and Pharmaceutical Science | 1 | 2% |
Chemistry | 1 | 2% |
Materials Science | 1 | 2% |
Other | 0 | 0% |
Unknown | 20 | 36% |