A cross sectional study to investigate internal hernia post left-sided colectomy preserving superior rectal artery.
IMA, Inferior mesenteric artery
Internal hernia
Laparoscopic surgery
Left colectomy
SMA, Superior mesenteric artery
SRA, Superior rectal artery
Stoma
Superior rectal artery
Journal
Annals of medicine and surgery (2012)
ISSN: 2049-0801
Titre abrégé: Ann Med Surg (Lond)
Pays: England
ID NLM: 101616869
Informations de publication
Date de publication:
Dec 2019
Dec 2019
Historique:
received:
02
07
2019
revised:
26
10
2019
accepted:
28
10
2019
entrez:
26
11
2019
pubmed:
26
11
2019
medline:
26
11
2019
Statut:
epublish
Résumé
and Purpose: Intestinal obstruction caused by an internal hernia projecting through a mesenteric defect is a rare sequela of laparoscopic colectomy, as surgeons usually leave such defects open. In this study, we investigated cases of internal hernia after laparoscopic left-sided colectomy. Data of 308 patients who underwent laparoscopic left hemicolectomy or sigmoidectomy at our institute between 2013 and 2018 were retrospectively reviewed. Patient characteristics and surgical variables were analyzed. The distance between the superior rectal artery (SRA) and abdominal aorta at the level of aortic bifurcation was measured using postoperative computed tomography in patients who underwent SRA-preserving colectomy. In all, 3 patients (0.97%), all of whom had undergone colostomy without anastomosis and with SRA preservation, developed internal hernia passing between the SRA and the aorta. The distance between the SRA and abdominal aorta in patients who underwent ostomy was significantly more than that in patients who underwent non-ostomy (10.6 mm vs. 4.7 mm, respectively, p < 0.001). SRA preservation and stoma construction are potential risk factors for internal hernia after laparoscopic left-sided colectomy. Lifting of the SRA due to stoma construction possibly enlarges the space between the SRA and aorta. When colostomy is created, it is important to evaluate the space behind the SRA.
Sections du résumé
BACKGROUND
BACKGROUND
and Purpose: Intestinal obstruction caused by an internal hernia projecting through a mesenteric defect is a rare sequela of laparoscopic colectomy, as surgeons usually leave such defects open. In this study, we investigated cases of internal hernia after laparoscopic left-sided colectomy.
METHODS
METHODS
Data of 308 patients who underwent laparoscopic left hemicolectomy or sigmoidectomy at our institute between 2013 and 2018 were retrospectively reviewed. Patient characteristics and surgical variables were analyzed. The distance between the superior rectal artery (SRA) and abdominal aorta at the level of aortic bifurcation was measured using postoperative computed tomography in patients who underwent SRA-preserving colectomy.
RESULTS
RESULTS
In all, 3 patients (0.97%), all of whom had undergone colostomy without anastomosis and with SRA preservation, developed internal hernia passing between the SRA and the aorta. The distance between the SRA and abdominal aorta in patients who underwent ostomy was significantly more than that in patients who underwent non-ostomy (10.6 mm vs. 4.7 mm, respectively, p < 0.001).
CONCLUSIONS
CONCLUSIONS
SRA preservation and stoma construction are potential risk factors for internal hernia after laparoscopic left-sided colectomy. Lifting of the SRA due to stoma construction possibly enlarges the space between the SRA and aorta. When colostomy is created, it is important to evaluate the space behind the SRA.
Identifiants
pubmed: 31763040
doi: 10.1016/j.amsu.2019.10.026
pii: S2049-0801(19)30160-8
pmc: PMC6864359
doi:
Types de publication
Journal Article
Langues
eng
Pagination
124-128Informations de copyright
© 2019 The Author(s).
Déclaration de conflit d'intérêts
There are no conflicts of interest.
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