Wu JZ, Orita H, Zhang S, Egawa H, Yube Y, Kaji S, Oka S, Fukunaga T. Easy fixation effects the prevention of Peterson’s hernia and Roux stasis syndrome. World J Gastrointest Surg 2020; 12(8): 346-354 [PMID: 32904043 DOI: 10.4240/wjgs.v12.i8.346]
Corresponding Author of This Article
Tetsu Fukunaga, MD, PhD, Professor, Department of Gastroenterology and Minimally Invasive Surgery, Juntendo University Hospital, 3-1-3 Hongo, Bunkyo-ku, Tokyo 1138431, Japan. t2fukunaga@juntendo.ac.jp
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Jian-Zhong Wu, Hajime Orita, Shun Zhang, Hiroyuki Egawa, Yukinori Yube, Sanae Kaji, Shinichi Oka, Tetsu Fukunaga, Department of Gastroenterology and Minimally Invasive Surgery, Juntendo University School of Medicine, Juntendo University, Tokyo 1638001, Japan
Jian-Zhong Wu, Department of Gastroenterology Surgery, Suzhou Ninth People’s Hospital, Nantong University, Suzhou 215000, Jiangsu Province, China
Shun Zhang, Department of Surgery, Tongji University, Shanghai 200000, China
Author contributions: Fukunaga T, Wu JZ and Oka S designed the research; Kaji S, Wu JZ, Zhang S and Yube Y collected the clinical data; Yube Y and Egawa H analyzed the data; Wu JZ and Orita H wrote the paper; Fukunaga T corrected and approved the manuscript.
Institutional review board statement: This study was retrospective, and no interference with patients’ treatment was made. Thus, the approval by the Institutional Review Committee of Juntendo University Hospital was waived.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Tetsu Fukunaga, MD, PhD, Professor, Department of Gastroenterology and Minimally Invasive Surgery, Juntendo University Hospital, 3-1-3 Hongo, Bunkyo-ku, Tokyo 1138431, Japan. t2fukunaga@juntendo.ac.jp
Received: May 2, 2020 Peer-review started: May 2, 2020 First decision: May 24, 2020 Revised: May 31, 2020 Accepted: July 26, 2020 Article in press: July 26, 2020 Published online: August 27, 2020 Processing time: 111 Days and 8.9 Hours
ARTICLE HIGHLIGHTS
Research background
Roux-en-Y reconstruction has been one of the standard options after laparoscopic distal gastrectomy. Its complications include Petersen’s hernia and Roux stasis syndrome. Although Petersen’s hernia is a rare complication, it is difficult to diagnose and cause serious postoperative complications. Meanwhile, Roux stasis syndrome is widely reported and reduces the post-operative nutritional status of patients.
Research motivation
Many improved methods were invented for decreasing the incidence of Petersen’s hernia and Roux stasis syndrome, however, some of them are technically complex elements and time-consuming. We developed an easy and effective method to narrow the Petersen’s defect and reduce the development of Roux stasis syndrome using surgical techniques.
Research objectives
The primary objective of the study was to develop an easy and effective method to decrease the development of Petersen’s hernia and Roux stasis syndrome.
Research methods
We fixed Roux limb onto the duodenal stump in a smooth radian after Roux-en-Y reconstruction. Via this small improvement in Roux limb, Roux limb was placed to the right of the ligament of Treitz. This not only changed the anatomy of the Petersen’s defect, but it also kept a fluent direction of gastrointestinal retrospective analysis review of the data of 31 consecutive patients who was performed this technique between July 2015 and March 2017.
Research results
This improvement method took about 10 min. All patients were followed up for at least 3 year, and none of the patients developed postoperative complications related to internal hernia or Roux stasis syndrome.
Research conclusions
This 10 min technique is a very effective method to decrease the development of Petersen’s hernia and Roux stasis syndrome in patients who undergo laparoscopic distal gastrectomy
Research perspectives
In this study, we report a case series of a simple and effective method for decreasing the development of Petersen’s hernia and Roux stasis syndrome. Because of the length of follow up, our study did not provide enough data to show conclusions about long-term outcomes. We will continue to perform this technique and collect more data to prove the long-term effect of this technique.
