INTRODUCTION: The incidence and presentation of hiatal hernias after esophagectomy (HHAE) are not well characterized, and may be changing with increased survival from esophageal cancer. The aims of this study were to define the incidence and presentation of HHAE in our population of patients undergoing transhiatal esophagectomy (THE), as it may have implications for management. METHODS: A retrospective cohort study (2004-2013) was performed of esophageal cancer patients who underwent THE. To determine the presence or absence of HHAE independent of the original radiology report, a radiologist sub-specializing in body imaging independently reviewed post-operative computed tomography images. A time-to-event competing risk analysis was performed to estimate the cumulative incidence of HHAE. RESULTS: Among 192 patients, the two-year cumulative incidence of HHAE was 14 % (95 % confidence interval 7.5-21 %). Of the 22 patients determined to have HHAE by independent expert radiologist review, only 11 (50 %) were identified by the original interpreting radiologist. Seven patients were symptomatic, and each underwent hiatal hernia repair (4 via laparotomy, 3 via laparoscopy). CONCLUSION: HHAE is not rare and is often unrecognized. As more patients with esophageal cancer survive, the number of patients becoming symptomatic and requiring repair may also rise. Therefore, it is important to consider this diagnosis when following patients long-term after esophagectomy.
INTRODUCTION: The incidence and presentation of hiatal hernias after esophagectomy (HHAE) are not well characterized, and may be changing with increased survival from esophageal cancer. The aims of this study were to define the incidence and presentation of HHAE in our population of patients undergoing transhiatal esophagectomy (THE), as it may have implications for management. METHODS: A retrospective cohort study (2004-2013) was performed of esophageal cancerpatients who underwent THE. To determine the presence or absence of HHAE independent of the original radiology report, a radiologist sub-specializing in body imaging independently reviewed post-operative computed tomography images. A time-to-event competing risk analysis was performed to estimate the cumulative incidence of HHAE. RESULTS: Among 192 patients, the two-year cumulative incidence of HHAE was 14 % (95 % confidence interval 7.5-21 %). Of the 22 patients determined to have HHAE by independent expert radiologist review, only 11 (50 %) were identified by the original interpreting radiologist. Seven patients were symptomatic, and each underwent hiatal hernia repair (4 via laparotomy, 3 via laparoscopy). CONCLUSION: HHAE is not rare and is often unrecognized. As more patients with esophageal cancer survive, the number of patients becoming symptomatic and requiring repair may also rise. Therefore, it is important to consider this diagnosis when following patients long-term after esophagectomy.
Authors: Matthew D Taylor; Damien J LaPar; John P Davis; James M Isbell; Benjamin D Kozower; Christine L Lau; David R Jones Journal: Ann Thorac Surg Date: 2013-04-22 Impact factor: 4.330
Authors: Daniel Vallböhmer; Arnulf H Hölscher; Till Herbold; Christian Gutschow; Wolfgang Schröder Journal: Ann Thorac Surg Date: 2007-12 Impact factor: 4.330
Authors: Dhakshina Moorthy Ganeshan; Arlene M Correa; Priya Bhosale; Ara A Vaporciyan; David Rice; Reza J Mehran; Garrett L Walsh; Revathy Iyer; Jack A Roth; Steven G Swisher; Wayne L Hofstetter Journal: Ann Thorac Surg Date: 2013-06-25 Impact factor: 4.330
Authors: David E Messenger; Simon M Higgs; Simon J Dwerryhouse; David F Hewin; Mark N Vipond; Hugh Barr; Martin S Wadley Journal: Surg Endosc Date: 2014-07-10 Impact factor: 4.584
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