Surgery, Gastroenterology and Oncology

Background: Parahiatal hernia is rare complication after esophagectomy. Is a rare form of diaphragmatic hernia, and its exact incidence is unknown. We report a case of para-hiatal hernia following laparoscopic esophagectomy, successfully managed laparoscopically. Case presentation: 63-year-old female, presenting a distal oesophageal adenocarcinoma, admitted in our Hospital in July 2018. The clinical TNM classification was T3, N2, M0 (stage IIIB). Initially treated by chemotherapy with partial response, after restaging a laparoscopic transhiatal esophagectomy with gastric tube reconstruction was performed. Two months after the surgery, the patient presented dyspnoea and left thoracic pain. Computed tomography confirmed presence of colon in the left hemithorax. The patient was diagnosed with parahiatal hernia secondary to the previous esophagectomy and underwent laparoscopic hernia repair. The incarcerated colon was repositioned in the abdominal cavity and defect was repaired using a composite mesh. The patient was discharged on postoperative day 7. No hernia recurrence was detected 12 month after surgery.

Conclusions: In this case, the laparoscopic approach showed to be safe and effective for the diagnosis and repair of parahiatal hernia following laparoscopic esophagectomy. The treatment of parahiatal hernia consists of reduction of the abdominal content into the abdominal cavity, assessment of the gastric tube and herniated bowel viability, and closure of the hiatus defect around the gastric conduit.

Full Text Sources:
Abstract:   
Views: 2036