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Diaphragmatic herniation following oesophagectomy
J W van Sandick1, J L Knegjens, J J van Lanschot
1Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands.
The British Journal of Surgery
|February 23, 1999
Summary
Intrathoracic herniation occurred in 4% of patients after esophageal resection. Extended diaphragmatic incisions increase this risk, necessitating potential narrowing of the opening to prevent complications.
Area of Science:
- Thoracic surgery
- Gastrointestinal surgery
- Surgical complications
Background:
- Intrathoracic herniation of abdominal viscera is a critical condition often exacerbated by delayed diagnosis.
- Esophageal resection poses a risk for diaphragmatic herniation, impacting patient outcomes.
Purpose of the Study:
- To determine the incidence of intrathoracic herniation following esophageal resection.
- To identify factors contributing to the occurrence of postoperative hernias.
Main Methods:
- Review of chest radiographic studies in 218 patients post-esophagectomy (1993-1997).
- Analysis of predisposing factors associated with hernia formation.
Main Results:
- Diaphragmatic herniation detected in 4% (9/218) of patients.
- Hernias occurred both early (within 1 week) and late post-operation.
- Extended diaphragmatic incision and partial diaphragm resection significantly increased hernia risk (P=0.02).
Conclusions:
- Diaphragmatic herniation is a notable complication (4%) after esophagectomy.
- Modifications to diaphragmatic anatomy, such as narrowing the opening after extended disruption, may prevent herniation.
- Early awareness and prevention strategies are crucial to avoid intestinal obstruction and strangulation.