Closure of Petersen's defect in gastrectomy for gastric cancer: an interrupted time series analysis from a high-volume institution in China.
PURPOSE
Petersen'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).


METHODS
Patients 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.


RESULTS
Among 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).


CONCLUSIONS
PD closure is recommended after gastrectomy for gastric cancer, as the rates of PH and SPH were significantly decreased.
['Pan|Tao|T|', 'Wang|Hui|H|', 'Liu|Kai|K|', 'Chen|Xin-Zu|XZ|', 'Zhang|Wei-Han|WH|', 'Chen|Xiao-Long|XL|', 'Yang|Kun|K|', 'Zhang|Bo|B|', 'Zhou|Zong-Guang|ZG|', 'Hu|Jian-Kun|JK|']
D000713:Anastomosis, Roux-en-Y D002681:China D005743:Gastrectomy D015390:Gastric Bypass D046449:Hernia, Abdominal D006801:Humans D065186:Interrupted Time Series Analysis D010535:Laparoscopy D012189:Retrospective Studies D013274:Stomach Neoplasms
Gastrectomy Gastric cancer Petersen’s hernia