Hiatal Hernia After Esophagectomy for Cancer

Abstract

HH is a significant long-term complication after esophagectomy, occurring in a substantial proportion of the patients. The occurrence of HH after MIE and open esophagectomy is comparable. Emergency operation is associated with dismal outcomes and should be avoided.

Early outcomes of two‐stage minimally invasive oesophagectomy in an Australian institution

“…Reoperation for hiatus hernia occurred in five patients (8%). The largest study to review hiatal hernia in MIO was Brenkman et al . The suspected rate of hiatal hernia formation after MIO is between 7 and 10% .…”

“…The largest study to review hiatal hernia in MIO was Brenkman et al . The suspected rate of hiatal hernia formation after MIO is between 7 and 10% . The proposed theory is that fewer adhesions form, allowing movement of abdominal contents through the hiatus.…”

“…Advantages of MIO are less blood loss, better pain control, fewer pulmonary complications and better cosmesis . This is at the price of a longer procedure and an increased occurrence of complex hiatal hernias containing bowel . The oncological clearance measured by the lymph node clearance is equivalent .…”

Double trouble: two sites of internal hernia following total gastrectomy

“…Diaphragmatic herniation is well documented following oesophagectomy and gastrectomy, with a reported incidence of 2.8% . Risk factors include tumours at the cardia, diabetes, obesity and transhiatal oesophageal resections . Excision of a wider cuff of crural tissue to ensure an oncologically complete resection for tumours at or near the gastro‐oesophageal junction is clearly a risk factor.…”

“…1 Risk factors include tumours at the cardia, diabetes, obesity and transhiatal oesophageal resections. 1,2 Excision of a wider cuff of crural tissue to ensure an oncologically complete resection for tumours at or near the gastro-oesophageal junction is clearly a risk factor. Such excisions also risk breaching the pleura and exposing abdominal contents to negative pressures of the thoracic cavity.…”