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Session: ePoster Monitor 5-Colon and Colorectal Cancer 2

eP286 - A Rare but Serious Complication-Internal Hernias and Upper Gastrointestinal Obstruction After Left Hemicolectomy: A Multicenter Retrospective Study

Sunday, June 2, 2024
9:30 AM – 9:35 AM ET, USA
Location: Baltimore Convention Center, Room 318-320

    Author(s)

  • XR

    Xianghai Ren, n/a

    Associate chief physician
    Zhongnan Hospital of Wuhan University, Wuhan
    Wuhan, Hubei, China (People's Republic)

    Disclosure information not submitted.

  • SY

    Siyuan Yin, n/a

    Graduate student of colorectal and anal Surgery, Zhongnan Hospital, Wuhan University
    Department of Colorectal and Anal Surgery, Zhongnan Hospital, Wuhan University
    wuhan, Hubei, China (People's Republic)

    Disclosure information not submitted.

    • ePoster Presenter(s)

  • Congqing Jiang

    Chair in the Department of Colorectal and Anal Surgery in Zhongnan Hospital of Wuhan University
    Zhongnan Hospital of Wuhan University, Wuhan
    Zhongnan Hospital of Wuhan University
    Wuhan, Hubei, China (People's Republic)

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

Purpose/Background: Although mesenteric-related internal hernias after left hemicolectomy are rare, they may cause serious complications such as acute intestinal necrosis. This study aimed to explore the potenital risk factors for internal hernias/upper gastrointestinal obstruction (IH/UGO) after left hemicolectomy.Methods/Interventions: We retrospectively reviewed files of colon cancer patients who underwent left hemicolectomy treatment in 9 tertiary hospitals from January 2018 to August 2023. Baseline informations, surgical procedures, and early postoperative complications were recorded and analyzed.Results/Outcomes: A total of 315 patients were included in this study. IH/UGO was diagnosed by postoperative imaging (CT/abdominal plain film examination). Seven patients (2.2%) developed IH/UGO (IH/UGO group), of which three patients were cured with conservative treatment and four underwent re-operation. During the surgery, we found that patients’ jejunum entered the mesenteric hiatus generated after left hemicolectomy and formed an adhesion with the surgical area. Compared with 308 patients who did not suffer IH/UGO (non-IH/UGO group) (with comparable baseline data between groups), the IH/UGO group lacked surgical procedures to close the mesenteric hiatus, and there was a statistically significant difference in the proportion of closed mesenteric defect compared to the non-IH/UGO group (0 vs. 47.1%; p=0.021); In the IH/UGO group, the length of the removed bowel was significantly longer than that in the non-IH/UGO group (24.3 ± 12.5 vs. 19.1 ± 6.5 cm; p=0.044).Conclusion/

Discussion: The lack of surgical procedures for closing the mesenteric defect after left hemicolectomy may increase the risk of IH/UGO, and the length of bowel resection may be related to the occurrence of IH/UGO. More clinical trials with larger cases are necessary to assess the risk of IH/UGO after left hemicolectomy.