The Incidence of Hiatal Hernia After Minimally Invasive Esophagectomy

Abstract

Hiatal herniation is not a rare event after MIE. It is also associated with significant health-care cost and may be lethal. Most occurrences appear to be asymptomatic and, if detected, can be repaired with good resolution of symptoms, minimal associated morbidity, and no mortality.

Diaphragmatic herniation following esophagogastric resectional surgery: an increasing problem with minimally invasive techniques?

“…The authors feel this technique avoids the difficulty in closing the defect via a thoracotomy and also avoids difficulty in delivering the conduit should it be narrowed first. Other surgeons, recognizing that colon is frequently found in a PODH, have described the suturing of the transverse colon to the abdominal wall as colopexy to potentially prevent PODH [19]. Without larger series, it is not clear which of these techniques is superior; however, our unit has now adopted a routine colopexy with permanent suture in minimally invasive and hybrid esophagectomy.…”

S3-Leitlinie – Diagnostik und Therapie der Plattenepithelkarzinome und Adenokarzinome des Ösophagus

“…In retrospektiven Studien zeigte sich auch eine erhöhte Rate an paragastralen Hiatushernien [346,347], Die Lymphknotenzahl ist in vielen Serien mit minimal invasiver Ösophagektomie geringer als in den Vergleichsgruppen mit offener Chirurgie.…”

Hiatal hernia after esophagectomy – a report of two cases

“…The risk factors for the development of hiatal hernia include intraperitoneal pressure exceeding thoracic pressure and distension of the esophageal hiatus [1, 4, 5, 7, 10]. Postoperative hiatal hernias occur more often after minimally invasive (2.7–26%) or robotic (up to 19.4%) esophagectomy than after conventional procedures because of the surgical technique [1, 3, 6, 7, 9]. In both presented cases, the displaced organ was the transverse colon.…”

“…The treatment of choice in such cases is surgical intervention. The abdominal approach is preferred, with a growing frequency of laparoscopy [1, 3, 5, 6, 9]. In the event of technical difficulties, additional thoracic access or even typical posterolateral thoracotomy may be required [8].…”