Comparative Analysis of Diaphragmatic Hernia Repair Outcomes Using the Nationwide Inpatient Sample Database

Paul, Subroto; Nasar, Abu; Port, Jeffrey L.; Lee, Paul C.; Stiles, Brendon C.; Nguyen, Andrew; Altorki, Nasser K.; Sedrakyan, Art

doi:10.1001/archsurg.2012.127

Cited by 36 publications

(40 citation statements)

References 14 publications

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“…An extensive description of the NIS and the collection and maintenance of data within the database is described elsewhere [8,9] (available at: http://www.hcup-us.ahrq.gov/nisoverview. jsp).…”

Section: Data Sourcementioning

confidence: 99%

A Population-Based Analysis of Robotic-Assisted Mitral Valve Repair

Paul

Isaacs

Jalbert

et al. 2015

The Annals of Thoracic Surgery

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Section: Data Sourcementioning

confidence: 99%

A Population-Based Analysis of Robotic-Assisted Mitral Valve Repair

Paul

Isaacs

Jalbert

et al. 2015

The Annals of Thoracic Surgery

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“…Every one of these methods has their advantages and flaws. For example, the thoracotomy approach is considered by many authors to be the elective approach, and yet, it is proven to be associated with a longer hospital stay and a high risk of pulmonary embolism [18]. In our case, the surgical team chose the laparotomy approach, using a right subcostal incision.…”

Section: Discussionmentioning

confidence: 94%

Diaphragmatic hernia following a liver resection: A rare cause of bowel obstruction

Outznit¹,

Zahra²,

Laila³

2018

Int J Case Rep Images

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Introduction: Delayed presentation of an iatrogenic diaphragmatic injury is rare. We report the case of a diaphragmatic hernia associated with a bowel obstruction occurring as a delayed complication of a right liver resection. This report emphasizes the rareness of such surgical outcome and the main CT-scan features of a diaphragmatic rent are discussed along with it. Case Report: A 30-year-old female was admitted to our emergency department with a clinical acute bowel obstruction syndrome. A chest and abdomen CT-scan revealed an ascent and strangulation by the entanglement of some jejunal loops through a right diaphragmatic hernia. A compression of the lung and the mediastinum were also observed. The patient was admitted to surgery. The non-viable ischemic loops were cut off, and the diaphragmatic defect is repaired after the reintegration of the abdominal structures and patient recovered uneventfully. Conclusion: Acquired diaphragmatic hernias are very rarely present on the right side. The CT scan findings suggestive of a diaphragmatic rent are highlighted and they should be carefully looked out for by the radiologist.

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“…It needs to be clarified whether or not the stomach has entirely migrated into thorax though the diaphragmatic defect, especially in the patient who had previously received thoracic or abdominal surgery. Needless to say, a thoracoabdominal approach could have been used as a most reliable approach for managing diaphragmatic hernia (1). Considering with the possibility of intrathoracic adhesions and the feasibility of management of the gastric perforation, we chose the transabdominal approach in this case.…”

Section: Discussionmentioning

confidence: 99%

“…Iatrogenic diaphragmatic hernia is rare complications of thoracic or abdominal surgery, having been described following esophagectomy (1), gastrectomy (2), laparoscopic cholecystectomy (3), and nephrectomy (4). An acute presentation with a strangulated or an obstructed viscus may present a diagnostic dilemma and require urgent resection and repair.…”

Section: Introductionmentioning

confidence: 99%

http://jtd.amegroups.com/article/view/7577/7006 http://jtd.amegroups.com/article/view/7521/7007 http://jtd.amegroups.com/article/view/7499/7008 http://jtd.amegroups.com/article/view/7520/7009 http://jtd.amegroups.com/article/view/7094/7010 http://jtd.amegroups.com/article/view/7603/7011 http://jtd.amegroups.com/article/view/7490/7012 http://jtd.amegroups.com/article/view/7243/7013 http://jtd.amegroups.com/article/view/7045/7014 http://jtd.amegroups.com/article/view/7224/7015 http://jtd.amegroups.com/articl

Pan¹,

Zhang²,

Zhao³

et al. 2016

J. Thorac. Dis.

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Postoperative iatrogenic diaphragmatic hernia after thoracoscopic lobectomy is extremely rare. We present a 55-year-old female patient who developed an iatrogenic diaphragmatic hernia with gastric perforation several months after VATS (video-assisted thoracic surgery) left upper lobectomy with systematic lymphadenectomy. During the readmission, urgent laparotomy was performed. Intraoperatively, the choledochoscopy was introduced into left thoracic cavity through the diaphragmatic defect for dissecting the secondary inflammatory adhesions and achieving satisfactory hemostasis. It appears to be an efficient and feasible approach for the patients who have been diagnosed as delayed diaphragmatic hernia concomitant with remarkable intra-abdominal findings and have a history of thoracic surgery. We consider that delayedonset diaphragmatic hernia should be suspected in patients complaining of nausea or vomiting after VATS procedure, although it is very rare. Figure 1B). The diagnosis of diaphragmatic hernia with gastric perforation was confirmed by barium swallow ( Figure 1C). Therefore, urgent laparotomy was scheduled. Intraoperatively, the stomach was incarcerated in the chest through the diaphragmatic defect (Figure 2A). The thoracic cavity was also inspected closely under the choledochoscopy which was inserted through the diaphragmatic defect. Due to the secondary inflammation of perforation, the adhesion which located between the lesser curvature of stomach and thorax was carefully dissected. Meanwhile, the thoracic hemostasis was verified using by ultrasonic activated scissor under the choledochoscopy ( Figure 2B). Subsequently, the stomach was gently reduced into the abdominal cavity. On account of gastric gangrene and secondary perforation, partial stomach was needed to be resected and nasojejunal tube was placed as well. Thereafter, the diaphragmatic defect was repaired with non-absorbable interrupted sutures. The postoperative recovery of the second surgery was uneventfully. Up to present, the patient was still well and no evidence of cancer recurrence was detected. DiscussionIatrogenic diaphragmatic hernia is a rare complication of thoracic and abdominal surgery (5). The low incidence of iatrogenic diaphragmatic hernia might be the result of a high misdiagnosis rate. Though the rare occurrence of J Thorac Dis 2016;8(6):E399-E402 jtd.amegroups.com iatrogenic diaphragmatic hernia, the mortality following emergency surgery for strangulated or perforated bowel or stomach rises to between 20% and 80% (6). To our knowledge, no document was found to describing the delayed complication several months after VATS left upper lobe (LUL) lobectomy. In this case, the left lower lobe (LLL) was completely adhered to diaphragm and the adhesions had been dissected with ultrasonic scissor in the first surgery. After reviewing the initial surgical procedure which may lead to diaphragmatic hernia, we suppose that a weak point (or an imperceptible perforation) in the diaphragm might have been provoked by the ultrasoni...

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Comparative Analysis of Diaphragmatic Hernia Repair Outcomes Using the Nationwide Inpatient Sample Database

Cited by 36 publications

References 14 publications

A Population-Based Analysis of Robotic-Assisted Mitral Valve Repair

A Population-Based Analysis of Robotic-Assisted Mitral Valve Repair

Diaphragmatic hernia following a liver resection: A rare cause of bowel obstruction

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