Introduction: The purpose of the current study was to review the available literature on morbidly obese patients treated with laparoscopic Roux-en-Y gastric bypass (LRYGB) in order to assess the clinical outcomes of the routine closure of the mesenteric defects.
Methods: A literature search was performed in PubMed, Cochrane library, and Scopus, in accordance with the PRISMA guidelines.
Results: Nine studies met the inclusion criteria. A total of 16,520 patients were incorporated with a mean follow-up ranging from 34 to 120 months. The closure of the mesenteric defects was associated with a lower incidence of internal hernias (odds ratio, 0.25 [95% confidence interval 0.20, 0.31]; p < 0.01), small bowel obstruction (SBO) (0.30 [0.17, 0.52]; p < 0.0001) and reoperations (0.28 [0.15, 0.52]; p < 0.001). Both approaches presented similar complication rates and % excess weight loss (%EWL).
Conclusion: The present meta-analysis is the best currently available evidence on the topic and supports the routine closure of the mesenteric defects.
Keywords: Closure; Internal hernia; Mesenteric defects; RYGB; Roux-en-Y gastric bypass.