目的    分析胃癌根治术后内疝致小肠梗阻的临床特征并总结诊治经验。方法    回顾性分析2014年5月至2022年4月扬州大学临床医学院普通外科收治的15例胃癌根治术后发生内疝致小肠梗阻病人的临床资料。所有病人均进行手术治疗，随访观察临床疗效。结果    15例病人中Petersen疝9例，小肠系膜裂孔疝6例。发生内疝与胃癌根治术间隔时间为10（1～63）个月。12例病人入院后行急诊开放手术治疗，3 例经保守治疗无效后行开放手术治疗。7例Petersen疝病人经小肠复位后血供恢复，仅缝合关闭Petersen间隙；另2例病人术中证实小肠坏死，行坏死小肠切除、缝合关闭 Petersen间隙。6例小肠系膜裂孔疝中，5例行内疝复位、间断缝合系膜间隙，1例病人术中证实末端回肠绞窄坏死，行部分小肠切除术，缝合关闭系膜裂孔。所有病人术后均未发生Clavien-Dindo分级Ⅲ级或以上并发症，术后住院时间为（8.8±1.6）d。随访44（6～85）个月，2例间断缝合小肠系膜间隙病人再次出现小肠系膜裂孔疝。结论    临床中一旦怀疑内疝应尽早完善腹部CT检查并进行手术治疗，建议在胃癌根治术中常规使用不可吸收缝线连续缝合关闭系膜间隙，以减少内疝发生。

Clinical characteristics and management of internal hernia after gastrectomy in patients with gastric cancer               ZHANG Qi*，YU Wen-hao，ZHOU Jia-jie，et al. *Department of General Surgery，Northern Jiangsu People's Hospital，Clinical Medical College，Yangzhou University and Medical School of Nanjing University；General Surgery Institute of Yangzhou，Yangzhou University，Yangzhou 225000，China
Corresponding author：WANG Dao-rong，E-mail：wdaorong666@sina.com
ZHANG Qi, YU Wen-hao and ZHOU Jia-jie are the first authors who contributed equally to the article
Abstract    Objective    To analyze the clinical characteristics of internal hernia after radical resection of gastric cancer and summarize the experience of diagnosis and treatment. Methods    The clinical data of 15 patients with intestinal obstruction due to internal hernia confirmed during operation and who had undergone gastrectomy in the past admitted by Department of General Surgery, Northern Jiangsu People's Hospital, Clinical Medical College, Yangzhou University from May 2014 to April 2022 were analyzed retrospectively, all of whom underwent surgical treatment and the clinical effect was observed and followed up. Results    There were 15 patients in the whole group, including 9 Petersen hernias and 6 jejunojejunostomy mesenteric hernias; The symptoms were 10（1~63） months after gastrectomy. 12 patients underwent emergency laparotomy, and 3 patients received laparotomy after ineffective conservative treatment. In 7 patients with Petersen’s hernia, the blood supply was restored after intestinal reduction, and the Petersen space was closed. In 2 patients, intestinal necrosis was confirmed during the operation, and necrotic small bowel resection and closure of Petersen’s space were performed. 6 cases of jejunojejunostomy mesenteric hernias：5 cases of internal hernia were recovered and intermittently sutured jejunojejunostomy mesenteric defect. One patient was confirmed to have terminal ileal strangulation and necrosis during operation and underwent partial small bowel resection to close the jejunojejunostomy mesenteric defect. All patients did not have complications of Clavien-Dindo grade Ⅲ or above after operation. The overall postoperative hospitalization（8.8±1.6）days. After operation，2 patients with intermittent suture of mesenteric space developed jejunojejunostomy mesenteric hernias again. Conclusion    Once an internal hernia is suspected, an abdominal CT examination should be promptly completed, and surgical treatment should be initiated. In order to reduce the occurrence of internal hernia，we recommend the routine use of non-absorbable sutures for continuous closure of the mesentery gap during radical gastrectomy.