BS O01 Closure of mesenteric defects during laparoscopic roux-en-y gastric bypass surgery and its effect on internal hernia rates and small bowel obstruction: A Meta- Analysis
نویسندگان
چکیده
Abstract Background Roux-en-Y gastric bypass surgery is an important treatment for obesity and it's related diseases, however internal herniation small bowel obstruction from mesenteric defects can lead to reoperation in 10–16% of patients. This be early (<30 days) or late. Routine closure meso-jejunal defecfs and/or Petersens defect still not adopted worldwide. Our objective was systematically review analyse pooled data all studies, evaluating the impact routine on incidence hernia laparoscopic antecolic (RYGB) obesity. Secondary endpoints analysis included late (SBO), need reoperation, bleeding, anastomotic leak, marginal ulceration weight loss. Methods Ovid, MEDLINE, EMBASE Cochrane databases were searched 13 September 2021 using a combination MeSH non-MeSH terms, including ‘gastric bypass’, ‘mesenteric defect’, ‘hernia’, ‘small obstruction’. Studies comparing with non-closure included. Two researchers independently examined titles, then abstracts, finally, full text articles. Disagreements arbitrated senior author. Fixed- random-effect models used, as appropriate. Results have been reported 95% confidence intervals I-squared indices assess uniformity among results each outcome measured. Seventeen studies met criteria included, two randomised trials. A total 61,220 patients follow-up ranging 24–120 months. In group types lower (OR 0.22, CI 0.19, 0.26), SBO beyond 30 days less frequent 0.47, 0.44,0.52), rate 0.19,0.26). The within higher 1.34, 1.07,1.68). Conclusions new updates previous meta-analyses, adding eight additional almost 45,000 provides firm evidence that during reduces rates post-operative period. Closure should standard practice RYGB. notable group, postulated by some attributable technical factors, kinking jejunal anastomosis bleeding. must considered when closing defects.
منابع مشابه
Bowel obstruction after laparoscopic Roux-en-Y gastric bypass.
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ژورنال
عنوان ژورنال: British Journal of Surgery
سال: 2022
ISSN: ['1365-2168', '0007-1323']
DOI: https://doi.org/10.1093/bjs/znac404.006