Diaphragmatic hernia after Ivor Lewis esophagectomy for cancer: a retrospective analysis of risk factors and post-repair outcomes

• DOI: 10.21037/jtd-20-1974
• Publication Date: 2021-01-29T10:02:28Z
• Authors: Francesco Puccetti; Andrea Cossu; Paolo Parise; Lavinia Barbieri; Ugo Elmore; Agnese Carresi; Stefano De Pascale; Uberto Fumagalli ...; Riccardo Rosati
• Keywords: Esophagectomy; Univariate analysis

Esophageal cancer surgery has historically been associated with high levels of postoperative morbidity and mortality. Post-esophagectomy diaphragmatic hernia (PEDH) represents a potentially life-threatening surgical complication, incidence risk factors not clearly demonstrated. This study evaluates presenting characteristics repair outcomes in PEDH after Ivor Lewis esophagectomy for cancer.All consecutive patients who underwent esophageal between March 1997 April 2018 at two high-volume centers were included. The managed according to standardized follow-up care plan. primary included incidence, factor identification, results repair. Patient perioperative data collected multivariate analysis was performed identify PEDH.A total 414 enrolled 22 (5.3%) diagnosed during median period 16 (range, 6-177) months. All (73%) required treatment within 24 hours. mainly through laparoscopic approach (77.3%), an overall 22.7% one mortality case. length hospital stay 6 2-95) days, no early recurrences observed, although three (13.6%) cases relapsed over 10.1 months Univariate demonstrated statistically significant association neoadjuvant chemoradiotherapy (P=0.016), pathological complete response (P=0.001), lymph node harvest (P=0.024). On the other hand, identified [3.616 (1.384-9.449), P=0.009] [3.029 (1.140-8.049), P=0.026] as independent developing PEDH.PEDH relevant complication cancer, including 5.3% requiring Pathological found be PEDH, independently technique.