{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T07:57:32Z","timestamp":1774252652987,"version":"3.50.1"},"reference-count":33,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T00:00:00Z","timestamp":1770681600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T00:00:00Z","timestamp":1770681600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Gastric cancer continues to pose a significant global health burden, with gastrectomy being the primary curative treatment. However, the increased performing of laparoscopic gastrectomy (LG) has been associated with a rising incidence of postoperative internal hernia (IH), particularly Petersen's hernia (pH), which may lead to bowel strangulation and necrosis. This meta\u2010analysis aimed to compare the incidence of IH following LG versus open gastrectomy (OG) and to evaluate the preventive effect of Petersen's space closure on pH occurrence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic review and meta\u2010analysis were conducted using PubMed and Embase to identify studies published in the past 25\u00a0years that reported IH or pH after gastrectomy for gastric cancer. Eligible studies compared (1) the incidence of IH between LG and OG or (2) the incidence of pH between closure and nonclosure of Petersen's space. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using a random\u2010effects model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Five studies comparing LG and OG demonstrated a significantly higher risk of IH in the LG group (OR 2.81, 95% CI: 1.40\u20135.62). A subgroup analysis limited to total gastrectomy showed a nonsignificant trend toward increased IH risk after LG (OR 6.12). Additionally, five studies showed that closure of Petersen's space significantly reduced the risk of pH (OR 5.73, 95% CI: 1.59\u201320.67).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Laparoscopic gastrectomy is associated with an increased risk of internal hernia compared to open surgery for gastric cancer. The preventive closure of Petersen's space should be considered mandatory, particularly during Roux\u2010en\u2010Y reconstruction after gastrectomy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/wjs.70257","type":"journal-article","created":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T15:00:21Z","timestamp":1770735621000},"page":"703-712","source":"Crossref","is-referenced-by-count":0,"title":["Incidence of Internal and Petersen's Hernias Following Gastrectomy for Gastric Cancer: A Meta\u2010Analysis of Surgical Approach and Preventive Closure"],"prefix":"10.1002","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9061-6236","authenticated-orcid":false,"given":"Sang\u2010Ho","family":"Jeong","sequence":"first","affiliation":[{"name":"Department of Surgery Gyeongsang National University College of Medicine and Gyeongsang National University Changwon Hospital  Changwon Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rock Bum","family":"Kim","sequence":"additional","affiliation":[{"name":"Regional Cardiocerebrovascular Disease Center Gyeongsang National University Hospital  Jinju Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miyeong","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Gyeongsang National University College of Medicine and Gyeongsang National University Changwon Hospital  Changwon Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kyung Won","family":"Seo","sequence":"additional","affiliation":[{"name":"Department of Surgery Kosin University Gospel Hospital  Busan Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5798-4595","authenticated-orcid":false,"given":"Jae\u2010Seok","family":"Min","sequence":"additional","affiliation":[{"name":"Division of Foregut Surgery Korea University Anam Hospital  Seoul Republic of Korea"},{"name":"Department of Surgery Korea University College of Medicine  Seoul Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,2,10]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00423\u2010021\u201002371\u2010x"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10120\u2010019\u201000931\u20101"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.4103\/jmas.jmas_315_23"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464\u2010018\u20106584\u20103"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464\u2010013\u20103384\u20107"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/sle.0000000000000481"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.7602\/jmis.2021.24.1.18"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/0197\u20102456(86)90046\u20102"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/biomet\/37.3\u20104.256"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.2307\/2533446"},{"key":"e_1_2_10_12_1","volume-title":"Cochrane Handbook for Systematic Reviews of Interventions","author":"Higgins J. 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