Diaphragmatic hernia post-minimally invasive esophagectomy: a discussion and review of literature

G. Benjamin, A. Ashfaq, Y. H. Chang, K. Harold, D. Jaroszewski

Research output: Contribution to journalArticle

20 Scopus citations

Abstract

Background: Diaphragmatic hernia (DH) after esophagectomy is a known complication which can occur and the incidence may be higher after minimally invasive esophagectomy (MIE). A review of our cases involving post-MIE diaphragmatic hernias and the published literature is presented. Methods: A retrospective review of patients who underwent MIE from November 2006 to January 2013 was performed. An Embase and Pub Med literature search on diaphragmatic hernia post-esophagectomy was conducted from 1990 to 2013 and reviewed. Results: In total, 120 consecutive patients underwent MIE at our institution. Neoadjuvant chemoradiotherapy had been performed in 71.4 % of patients. The mean age was 65 ± 22 years and 85 % were male. Seven patients (5.8 %) were diagnosed with DH by radiographic imaging with 5 (71.4 %) requiring surgical intervention. Diagnosis was made at a median time of 3.4 months (range 1–45 months) after MIE. One patient recurred after repair and underwent a second repair. There were no related mortalities. In literature review, 11 publications reporting DH were reviewed documenting a total of 4669 esophagectomies, with 756 MIE. The incidence of DH observed was 121 (2.6 %) in all patients and 34 (4.5 %) in MIE. Two studies comparing open versus MIE also reported a higher incidence of DH in MIE. Conclusions: Post-esophagectomy diaphragmatic hernia can occur and may be underreported. Minimally invasive esophagectomy appears to have a higher incidence of postoperative herniation when compared to traditional, open esophagectomy.

Original languageEnglish (US)
Pages (from-to)635-643
Number of pages9
JournalHernia
Volume19
Issue number4
DOIs
StatePublished - Aug 25 2015

Keywords

  • Complications postoperative
  • Diaphragmatic hernia
  • Esophageal cancer
  • Esophagectomy

ASJC Scopus subject areas

  • Surgery

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    Benjamin, G., Ashfaq, A., Chang, Y. H., Harold, K., & Jaroszewski, D. (2015). Diaphragmatic hernia post-minimally invasive esophagectomy: a discussion and review of literature. Hernia, 19(4), 635-643. https://doi.org/10.1007/s10029-015-1363-8