Postoperative hiatal hernia after minimally invasive esophagectomy for esophageal cancer
Hironori Iwasaki, Tomokazu Tanaka, S. Miyake, Yukie Yoda, Hirokazu Noshirο
Abstract
BACKGROUND: Minimally invasive esophagectomy (MIE) can reduce various complications compared with conventional thoracotomic esophagectomy. However, several reports suggested that MIE promoted incidence of post-operative hiatal hernia (HH). In current reports, we retrospectively analyzed incidence and risk factors of HH development after MIE. METHODS: A total of 113 patients undergoing MIE (McKeown esophagectomy) at our institute from April 2009 to December 2015 were included in this study. Patients with clinical stage II and III received neoadjuvant chemotherapy (NAC). RESULTS: 13.7%, P=0.05). Sixty-six patients (58.4%) during the study period were administered NAC and 10 of 11 patients with HH (90.9%) received NAC according to the clinical stage, which was significantly more than in the non-HH group (P=0.02). Type and route of graft organ were not related to HH development. Moreover, the fixation of the conduit organ at the hiatus does not contribute to post-operative HH. CONCLUSIONS: In the current study, we showed that NAC was a major risk factor of HH development after MIE.