Hiatal hernia after oesophagectomy: a large European survey

Gust, Lucile; Nafteux, Philippe; Allemann, Pierre; Tuech, Jean Jacques; Nakadi, Issam El; Collet, Denis; Goèré, Diane; Fabré, J; Meunier, Brigitte; Dumont, F; Poncet, Gilles; Passot, Guillaume; Carrère, Nicolas; Mathonnet, Muriel; Lebreton, Gil; Theraux, J.; Marchal, Frcrossed; Barabino, Gabriele; Thomas, Philippe; Piessen, Guillaume; D’Journo, Xavier Benoît

doi:10.1093/ejcts/ezy451

Cited by 28 publications

(37 citation statements)

References 24 publications

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“…This procedure anchoring the stomach to the opened hiatus is recommended by Hamaloglu et al [8]. However, others do not support the beneficial effect of such a fixation, and they argue this poses unnecessary risk to the primary vascular supply of the gastric conduit [9,10]. Unfortunately, in our case, three and half years later, the transverse colon was prolapsed through the hiatus into the mediastinum despite fixation of the gastric conduit.…”

Section: Discussionmentioning

confidence: 65%

“…One possible hypothesis is intra-abdominal procedures causing postoperative hiatal hernia. Minimally invasive esophagectomies (MIE) are associated with a lower pulmonary complication rate, less abdominal pain, and shortened hospitalization period compared to an open procedure [1,4,9]; on the other hand, hiatal hernia following esophagectomy could be an increasing problem. Previous reports presumed that hiatal hernia occurs more often after MIE than open esophagectomy, because of fewer peritoneal adhesions in the hiatal region, resulting from minimal access techniques, such as thoracoscopic and laparoscopic surgery [11,12].…”

Section: Discussionmentioning

confidence: 99%

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Transverse colon perforation in the mediastinum after esophagectomy: a case report

et al. 2020

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Background: While anastomotic leakage, recurrent laryngeal nerve paralysis, and pneumonia are well-known complications of esophagectomy, the incidence of hiatal hernia after esophagectomy for carcinoma has been reported to only be between 0.6 and 10%. We report a very rare case of hiatal hernia with transverse colon rupture in the mediastinum after esophagectomy in a 65-year-old woman. Case presentation: The patient underwent definitive chemoradiotherapy for clinical stage IIA esophageal squamous cell carcinoma and salvage esophagectomy with gastric tube reconstruction through a posterior mediastinum route for residual carcinoma. Three years after the initial surgery, two metastatic nodules in the lateral and posterior segments of the liver were detected on follow-up CT and were treated with oral anticancer drugs. After 6 months, the patient was readmitted for anorexia. Upon admission, computed tomography revealed an ileus caused by a hiatal hernia. Emergent operative repair was performed; an incarcerated herniation of the transverse colon was perforated in the mediastinum, and partial transverse colon resection and colostomy were performed. Intensive care was required to control septic shock after surgery, and the patient was discharged on the 53rd postoperative day. Conclusions: Cases of hiatal hernia with digestive tract prolapsing into the mediastinum after esophagectomy with reconstruction through posterior mediastinum are rare but potentially life-threatening complications.

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Section: Discussionmentioning

confidence: 65%

Section: Discussionmentioning

confidence: 99%

Transverse colon perforation in the mediastinum after esophagectomy: a case report

et al. 2020

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“…Las hernias hiatales son una complicación potencialmente molesta de la esofagectomía. En una gran serie retrospectiva que involucró a más de 6000 pacientes sometidos a reparación de una hernia hiatal después de la esofagectomía, la incidencia de hernia hiatal después de una esofagectomía abierta y mínimamente invasiva (MIE) fue de 0,73 y 1,4 por ciento, respectivamente (Gust et al, 2019 Preocupaciones sobre la seguridad de los dispositivos recubiertos con paclitaxel para el tratamiento de la enfermedad arterial periférica (abril de 2019)…”

Section: Hernia De Hiato Después De Una Esofagectomía Abierta Y Mínimunclassified

“…19. Gust L, Nafteux P, Allemann P, et al (2019). Hernia de hiato después de la esofagectomía: una gran encuesta europea.…”

Section: Referencias Bibliográficasunclassified

Actualización sobre todos los avances en el campo de la cirugía

Macías

Intriago

2019

Vida y Salud

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Recibido: 12 de mayo de 2019Aprobado: 02 de junio de 2019Los nuevos centros de innovación quirúrgica están trabajando para definir el campo e identificar aspectos críticos de la promoción de la innovación quirúrgica. La responsabilidad como profesionales de la medicina es trabajar para comprender la innovación en cirugía, descubrir, traducir y comercializar avances para abordar problemas clínicos importantes y para apoyar el futuro de nuestra profesión de manera consistente y racional. El presente artículo de revisión contiene la síntesis de recientes avances en diferentes especialidades del campo de la cirugía que van desde la cirugía abdominal de pared y hernia, bariátrica, colorectal, debusto, gastrointestinal superior, endocrina, hepatobiliar y pancreática, de piel y tejido suave, de trauma y quemaduras, vascular y endovascular, el cuidado perioperativo, trasplantes así como otras especialidades quirúrgicas.

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“…These patients with HH often present with acute symptoms onset related to strangulation, necrosis, and perforation of the herniated viscera. Symptomatic HH mandates a surgical intervention, including reduction of the herniated intra-abdominal viscera and concomitant cruroplasty to reduce the risk of future recurrences [7]. Current knowledge about incidence, risk factors, and related outcomes is only supported by retrospective studies.…”

Section: Introductionmentioning

confidence: 99%

Diaphragmatic herniation after esophagogastric surgery: systematic review and meta-analysis

Bona

Lombardo

Matsushima

et al. 2021

Langenbecks Arch Surg

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Introduction The anatomy of the esophageal hiatus is altered during esophagogastric surgery with an increased risk of postoperative hiatus hernia (HH). The purpose of this article was to examine the current evidence on the surgical management and outcomes associated with HH after esophagogastric surgery for cancer. Materials and methods Systematic review and meta-analysis. Web of Science, PubMed, and EMBASE data sets were consulted. Results Twenty-seven studies were included for a total of 404 patients requiring surgical treatment for HH after esophagogastric surgery. The age of the patients ranged from 35 to 85 years, and the majority were males (82.3%). Abdominal pain, nausea/vomiting, and dyspnea were the commonly reported symptoms. An emergency repair was required in 51.5%, while a minimally invasive repair was performed in 48.5%. Simple suture cruroplasty and mesh reinforced repair were performed in 65% and 35% of patients, respectively. The duration between the index procedure and HH repair ranged from 3 to 144 months, with the majority (67%) occurring within 24 months. The estimated pooled prevalence rates of pulmonary complications, anastomotic leak, overall morbidity, and mortality were 14.1% (95% CI = 8.0–22.0%), 1.4% (95% CI = 0.8–2.2%), 35% (95% CI = 20.0–54.0%), and 5.0% (95% CI = 3.0–8.0%), respectively. The postoperative follow-up ranged from 1 to 110 months (mean = 24) and the pooled prevalence of HH recurrence was 16% (95% CI = 13.0–21.6%). Conclusions Current evidence reporting data for HH after esophagogastric surgery is narrow. The overall postoperative pulmonary complications, overall morbidity, and mortality are 14%, 35%, and 5%, respectively. Additional studies are required to define indications and treatment algorithm and evaluate the best technique for crural repair at the index operation in an attempt to minimize the risk of HH.

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Hiatal hernia after oesophagectomy: a large European survey

Cited by 28 publications

References 24 publications

Transverse colon perforation in the mediastinum after esophagectomy: a case report

Transverse colon perforation in the mediastinum after esophagectomy: a case report

Actualización sobre todos los avances en el campo de la cirugía

Diaphragmatic herniation after esophagogastric surgery: systematic review and meta-analysis

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