Hiatal Hernia After the Esophagectomy Repaired By Laparoscopic Surgery

Jun Iwabu, Hiroyuki Kitagawa, Tsutomu Namikawa, Michiya Kobayashi, Kazuhiro Hanazaki. Kochi Medical School


Laparoscopic surgery has an advantage at the point of less abdominal adhesion compared with open laparotomy. Since 2005, we had introduced the total laparoscopic gastric mobilization (TLGM) for esophagectomy as a less invasive surgery, and experienced a case of incarcerated hiatal hernia after the esophagectomy.
Case report
A 80-years old woman was admitted with acute abdominal pain and vomit. She had a history of the esophagectomy with TLGM for esophageal cancer 5 years ago. The computed tomography confirmed the incarcerated small bowel in the the right thoracic cavity through the hiatus, and collapse of the right lung. Under the diagnosis as the incarcerated hiatal hernia of the small bowel, the emerging laparoscopic surgery was performed.
There was no adhesion in the abdominal cavity, and the small intestine fell into the right thoracic cavity through the hiatus. Following small bowel returning, neither the ischemia nor the necrosis was observed. The hiatus was directly repaired without graft. Her postoperative course was uneventful.
The hiatal hernia is an unusual complication after the esophagectomy. It might be due to excessive hiatal enlargement and less adhesion by TLGM. The laparoscopic approach is feasible option of repair of this complication.

Session Number: Poster – Poster Presentations
Program Number: P289
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