ArticleSurgical endoscopy2016
Diaphragmatic herniation following esophagogastric resectional surgery: an increasing problem with minimally invasive techniques? : Post-operative diaphragmatic hernias.
Article in Surgical endoscopy, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
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Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 51 citations in OpenAlex.
- Diaphragmatic herniation after esophagogastric surgery: systematic review and meta-analysis.Langenbeck's archives of surgery · 2021Pooled it
- Post-esophagectomy hiatal hernia following minimally invasive esophagectomy in esophageal cancer patients.Surgical endoscopy · 2025Article
- Rare complications after esophagectomy: incidence, clinical features, risk factors, management, and prevention.Therapeutic advances in gastroenterology · 2025Review
- Obstructive shock and cardiac arrest due to diaphragmatic hernia after esophageal surgery: a case report.Surgical case reports · 2024Article
- Presentation and management of post-esophagectomy or Gastrectomy Hiatal Hernia.Hernia : the journal of hernias and abdominal wall surgery · 2024Article
- Open left diaphragm method enables safe surgery with a good visual field in a laparoscopic transhiatal approach for esophagogastric junction adenocarcinoma laparoscopic transhiatal reconstruction via an open left diaphragm method.Langenbeck's archives of surgery · 2024Article
- Persistent pneumothorax after laparoscopic appendectomy in a patient who had undergone radical esophagectomy 5 years before: possible relationship with vulnerability of the hiatus after esophagectomy: a case report.Journal of surgical case reports · 2024Article
- Postoperative Hiatal Hernia after Ivor Lewis Esophagectomy-A Growing Problem in the Age of Minimally Invasive Surgery.Journal of clinical medicine · 2023Article
- A rare and severe complication after minimally invasive esophagectomy: First case of a left-sided tension pneumothorax caused by intrathoracic perforation of the herniated transverse colon. Case report and literature review.Frontiers in gastroenterology (Lausanne, Switzerland) · 2023Article
- Fecopneumothorax due to gangrene and perforation of the colon in post-esophagectomy diaphragmatic hernia.Kardiochirurgia i torakochirurgia polska = Polish journal of cardio-thoracic surgery · 2022Article
- Trans-hiatal herniation following esophagectomy or gastrectomy: retrospective single-center experiences with a potential surgical emergency.Hernia : the journal of hernias and abdominal wall surgery · 2022Article
- Laparoscopic Repair of Acute Post-Esophagectomy Diaphragmatic Herniation Following Minimal Access Esophagectomy.Indian journal of surgical oncology · 2021Article
- Incidence, Diagnosis and Repair of a Diaphragmatic Hernia Following Hepatic Surgery: A Single Center Analysis of 3107 Consecutive Liver Resections.Journal of clinical medicine · 2021Article
- Hiatal Hernia with Acute Obstructive Symptoms After Minimally Invasive Oesophagectomy.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2021Article
- Impact of postoperative complications on survival after oesophagectomy for oesophageal cancer.BJS open · 2020Article
- Transverse colon perforation in the mediastinum after esophagectomy: a case report.Surgical case reports · 2020Article
- Diaphragmatic herniation following total gastrectomy: review of the long-term experience of a tertiary institution.Langenbeck's archives of surgery · 2019Review
- Internal hernia to the retrosternal space is a rare complication after minimally invasive esophagectomy: three case reports.Surgical case reports · 2019Article
- Emergency Laparoscopic Repair of Giant Left Diaphragmatic Hernia following Minimally Invasive Esophagectomy: Description of a Case and Review of the Literature.Case reports in surgery · 2018Article
- Dual incarcerated internal hernias after laparoscopic total gastrectomy with Roux-en-Y reconstruction for gastric cancer.BMJ case reports · 2017Article
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPost-operative diaphragmatic hernias (PODHs) are serious complications following esophagectomy or total gastrectomy. The aim of this study was to describe and compare the incidence of PODHs at a high volume center over time and analyze the outcomes of patients who develop a PODH.
methodsA prospective database of all resectional esophagogastric operations performed for cancer between January 2001 and December 2015 was analyzed. Patients diagnosed with PODH were identified and data extracted regarding demographics, details of initial resection, pathology, PODH symptoms, diagnosis and treatment.
resultsOut of 631 patients who had hiatal dissection for malignancy, 35 patients developed of PODH (5.5 % overall incidence). Median age was 66 (range 23-87) years. The incidence of PODH in each operation type was: 2 % (4/221) following an open 2 or 3 stage esophagectomy, 10 % (22/212) following laparoscopic hybrid esophagectomy, 7 % (5/73) following MIO, and 3 % (4/125) following total gastrectomy. The majority of patients had colon or small bowel in a left-sided hernia. Of the 35 patients who developed a PODH, 20 (57 %) patients required emergency surgery, whereas 15 (43 %) had non-urgent repair. The majority of the patients had had suture repair (n = 24) or mesh repair (n = 7) of the diaphragmatic defect. Four patients were treated non-operatively. In hospital post-operative mortality was 20 % (4/20) in the emergency group and 0 % (0/15) in the elective group. Further hernia recurrence affected seven patients (n = 7/27, 26 %) and 4 of these patients (15 %) presented with multiple recurrences.
conclusionPODH is a common complication following hybrid esophagectomy and MIO. Given the high mortality from emergency repair, careful thought is needed to identify surgical techniques to prevent PODH forming when minimal access esophagectomy are performed. Upper GI surgeons need to have a low index of suspicion to investigate and treat patients for this complication.
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