Diaphragmatic herniation after esophagectomy for carcinoma of the esophagus: a report of two cases

Abstract

Diaphragmatic herniation after esophagectomy for carcinoma of the esophagus is a rare but preventable postoperative complication. For patients with symptoms, surgical repair of the hernia is recommended to prevent the potentially disastrous complications. In patients with asymptomatic hernias, a watchful waiting approach is reasonable. To prevent diaphragmatic herniation, we emphasize the importance of routine narrowing of the hiatus so that the surgeon can introduce three or four fi ngers and recommend awareness of the possibility of diaphragmatic herniation in patients with symptoms of intestinal obstruction. We report two cases of diaphragmatic herniation after esophagectomy for carcinoma of the esophagus, and estimate the incidence of herniation and assess surgical results on the basis of reported cases in the English-language literature.

Transverse colon perforation in the mediastinum after esophagectomy: a case report

“…The incidence rate of postoperative diaphragmatic hernias after esophagectomy is estimated to be between 0.6 and 10% [1,6]. This rate may vary depending on the operative technique, such as When the retrosternal route is used, the hiatus is often closed tightly, and diaphragmatic herniation will occur less frequently [7]. On the other hand, in many Western countries, the mediastinal route is often used for adenocarcinoma of the esophagus.…”

“…Another study suggested that tissue fragility after neoadjuvant chemoradiation could be strongly related to risk factors for postoperative hiatal hernia [3,7]. Late diaphragmatic hernias are associated with progressive hiatal dilatation secondary to diaphragm weakness or increased intra-abdominal pressure caused by a gibbus deformity [3,7,13].…”

Intrapericardial diaphragmatic hernia into the pericardium after esophagectomy: a case report

“…Although some cases of diaphragmatic hernia after esophagectomy have been reported, the hernia orifice in these cases was located at the hiatus only [ 7 ]. No reports have described the hernia orifice at the pericardium, as in the present case.…”

Laparoscopic management of incarcerated diaphragmatic hernia 6 months post mini-invasive esophagectomy and retrosternal gastroplasty

“…Существуют данные, что послеоперационные грыжи диафрагмы могут развиваться только при ор-тотопическом проведении трансплантата, так как при ретростернальном проведении желудочного стебля пищеводное отверстие диафрагмы наглухо ушивается [4]. И хотя у части больных это ослож-нение развивается в раннем послеоперационном периоде, в 2 / 3 случаев послеоперационные диафраг-мальные грыжи выявляются в сроки от 1 до 44 мес и даже через 7 лет после вмешательства [5].…”