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Comparison between the mesenteric fixation method (MEFIX) and conventional methods at preventing the occurrence of

Jae Kyun Park1, Dae Hwan Kim1, Tae-Yong Jeon1

  • 1Department of Surgery, Pusan National University Hospital, Pusan National University School of Medicine, Biomedical Institution, Busan, 49241, Republic of Korea.

Trials
|January 3, 2024
PubMed
Abstract

Insights

The study compares the mesenteric fixation (MEFIX) method to conventional techniques for closing Petersen's defects after gastric surgery. MEFIX is anticipated to be a faster, simpler closure method without increasing complications.

Area of Science:

  • Gastrointestinal surgery
  • Surgical oncology
  • Minimally invasive surgery

Background:

  • Petersen's hernia is a complication following Billroth-II (B-II) or Roux-en-Y (REY) anastomosis.
  • Defect closure is a key strategy to prevent Petersen's hernia.
  • Laparoscopic or robotic gastrectomy increases the risk of internal hernias.

Purpose of the Study:

  • To compare the incidence of severe bowel obstruction (Clavien-Dindo grade III) caused by Petersen's hernia.
  • To evaluate the efficacy of the mesenteric fixation (MEFIX) method versus conventional closure techniques.
  • To assess postoperative complications associated with different Petersen's defect closure methods.

Main Methods:

  • Prospective, single-blind, non-inferiority randomized controlled multicenter trial.
  • Inclusion of patients with gastric cancer (stages I-III) undergoing B-II or REY anastomosis after laparoscopic or robotic gastrectomy.
  • Random assignment to either conventional Petersen's defect closure or the MEFIX method.

Main Results:

  • Primary endpoint: number of patients requiring surgery for Petersen's hernia-related bowel obstruction within 3 years.
  • Secondary endpoints to assess surgical site infections, intra-abdominal fluid collection, and other complications.
  • Data analysis to determine non-inferiority of the MEFIX method.

Conclusions:

  • The MEFIX method is expected to demonstrate non-inferiority to conventional closure for preventing severe bowel obstruction.
  • This approach aims for a quicker and simpler closure of Petersen's defects.
  • The study anticipates no increase in postoperative complications with the MEFIX technique.
Keywords:
GastrectomyGastric neoplasmInternal herniaMinimally invasive surgery

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