BACKGROUND: Herniation of abdominal contents via the diaphragmatic hiatus is a potentially life-threatening complication of esophagectomy. Mounting evidence suggests that hiatal hernias are more common following minimally invasive esophagectomy. Therefore, post-esophagectomy hiatal hernia and its treatment bear increasing significance. METHODS: We retrospectively reviewed the records of five patients with hiatal hernia following esophagectomy over a 5-year period. RESULTS: Successful laparoscopic reduction of a post-esophagectomy hiatal hernia was done without mesh reinforcement in three patients. One patient underwent mesh reinforcement. One patient was found to have carcinomatosis upon laparoscopic inspection, and repair of the hiatal hernia was abandoned. There were no perioperative deaths or complications. One patient developed a recurrent hiatal hernia 14 months after repair of the initial hiatal hernia. Patients were discharged within a mean of 1.75 days after surgical repair. DISCUSSION: We have successfully used laparoscopy to treat hiatal hernias after esophagectomy. The benefits conferred by laparoscopy, including better visualization of the right gastroepiploic artery supplying the gastric conduit, minimally invasive evaluation of the field for metastasis, and shorter recovery time, make it our favored approach. Here, we describe our experience with hiatal hernia following esophagectomy and our operative technique.
BACKGROUND: Herniation of abdominal contents via the diaphragmatic hiatus is a potentially life-threatening complication of esophagectomy. Mounting evidence suggests that hiatal hernias are more common following minimally invasive esophagectomy. Therefore, post-esophagectomy hiatal hernia and its treatment bear increasing significance. METHODS: We retrospectively reviewed the records of five patients with hiatal hernia following esophagectomy over a 5-year period. RESULTS: Successful laparoscopic reduction of a post-esophagectomy hiatal hernia was done without mesh reinforcement in three patients. One patient underwent mesh reinforcement. One patient was found to have carcinomatosis upon laparoscopic inspection, and repair of the hiatal hernia was abandoned. There were no perioperative deaths or complications. One patient developed a recurrent hiatal hernia 14 months after repair of the initial hiatal hernia. Patients were discharged within a mean of 1.75 days after surgical repair. DISCUSSION: We have successfully used laparoscopy to treat hiatal hernias after esophagectomy. The benefits conferred by laparoscopy, including better visualization of the right gastroepiploic artery supplying the gastric conduit, minimally invasive evaluation of the field for metastasis, and shorter recovery time, make it our favored approach. Here, we describe our experience with hiatal hernia following esophagectomy and our operative technique.
Authors: Surya S A Y Biere; Mark I van Berge Henegouwen; Kirsten W Maas; Luigi Bonavina; Camiel Rosman; Josep Roig Garcia; Suzanne S Gisbertz; Jean H G Klinkenbijl; Markus W Hollmann; Elly S M de Lange; H Jaap Bonjer; Donald L van der Peet; Miguel A Cuesta Journal: Lancet Date: 2012-05-01 Impact factor: 79.321
Authors: Daniel Vallböhmer; Arnulf H Hölscher; Till Herbold; Christian Gutschow; Wolfgang Schröder Journal: Ann Thorac Surg Date: 2007-12 Impact factor: 4.330
Authors: Michael S Kent; James D Luketich; Wilson Tsai; Patricia Churilla; Michael Federle; Rodney Landreneau; Miguel Alvelo-Rivera; Matthew Schuchert Journal: Ann Thorac Surg Date: 2008-09 Impact factor: 4.330
Authors: Enrico Erdas; Gian Luigi Canu; Luca Gordini; Paolo Mura; Giulia Laconi; Giuseppe Pisano; Fabio Medas; Pietro Giorgio Calò Journal: Case Rep Surg Date: 2018-09-12