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[Hiatal hernia after esophagectomy]
A B Ryabov1, O V Pikin1, V M Khomyakov1
1Herzen Moscow Oncology Research Institute, Moscow, Russia.
Khirurgiia
|November 25, 2024
Summary
Hiatal hernias are twice as common after minimally invasive esophagectomies. Prompt surgical intervention is crucial for symptomatic hernias to prevent life-threatening complications like strangulation.
Area of Science:
- Gastroenterology and Surgical Oncology
- Thoracic Surgery
- Minimally Invasive Surgery
Context:
- Esophagectomy for esophageal cancer can lead to postoperative complications.
- Hiatal hernias represent a significant, though infrequent, complication following esophagectomy.
- Understanding risk factors and management strategies is vital for patient outcomes.
Purpose:
- To analyze the incidence, causes, and surgical treatment of hiatal hernias post-esophagectomy.
- To evaluate the technical aspects of surgical repair and preventative measures.
- To compare hernia rates between open and minimally invasive esophagectomy approaches.
Summary:
- A retrospective analysis of 161 esophagectomy patients (2018-2023) revealed a 3.7% incidence of hiatal hernias.
- Hernias were more frequent (4.4%) after minimally invasive procedures compared to open surgery (2.9%).
- Surgical repair was required for symptomatic hernias, with one fatality due to strangulation and respiratory failure.
Impact:
- Minimally invasive esophagectomy techniques may increase hiatal hernia risk.
- Aggressive surgical management is recommended for symptomatic hiatal hernias.
- Avoiding wide diaphragmotomy and excessive intra-abdominal pressure may reduce complication rates.
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