Diaphragmatic herniation after thoracolaparoscopic esophagectomy for carcinoma of the esophagus: a report of six cases

Abstract

Diaphragmatic herniation after esophagectomy for carcinoma of the esophagus is a rare postoperative complication. Several recent reports reveal that minimally invasive esophagectomy (MIE) with mediastinal reconstruction is associated with a higher incidence of herniation compared with open esophagectomy. Thoracolaparoscopic esophagectomy (TLE), also called "total MIE", results in fewer peritoneal adhesions around the hiatal region of both the thoracic and abdominal cavities. This may cause abdominal contents to be taken up to the thoracic cavity. We report six cases of diaphragmatic herniation after TLE. Of these, five patients underwent surgical repair and one patient without symptoms is followed up carefully. In TLE, anchoring the gastric conduit to the hiatus is essential for preventing herniation.

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