Title :

Hiatal hernia after oesophagectomy: a large European survey

Author(s) :

Gust, Lucile [Auteur]
Departement de chirurgie thoracique et des maladies de l'oesophage [Hôpital Nord - APHM]
Nafteux, Philippe [Auteur]
University Hospital Gasthuisberg [Leuven]
Allemann, Pierre [Auteur]
Centre Hospitalier Universitaire Vaudois = Lausanne University Hospital [Lausanne] [CHUV]
Tuech, Jean-Jacques [Auteur]
Laboratoire d'éthique médicale et médecine légale [LEM]
El Nakadi, Issam [Auteur]
Université libre de Bruxelles [ULB]
Collet, Denis [Auteur]
Goere, Diane [Auteur]
Département de chirurgie générale [Gustave Roussy]
Fabre, Jean-Michel [Auteur]
Centre Hospitalier Régional Universitaire [Montpellier] [CHRU Montpellier]
Meunier, Bernard [Auteur]
Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou]
Dumont, Frédéric [Auteur]
Poncet, Gilles [Auteur]
Hospices Civils de Lyon [HCL]
Passot, Guillaume [Auteur]
Ciblage thérapeutique en Oncologie [EA3738]
Carrere, Nicolas [Auteur]
Service Chirurgie viscérale et digestive [CHU Toulouse]
Mathonnet, Muriel [Auteur]
Homéostasie Cellulaire et Pathologies [HCP]
Lebreton, Gil [Auteur]
CHU Caen
Theraux, Jérémie [Auteur]
Centre Hospitalier Régional Universitaire de Brest [CHRU Brest]
Marchal, Frédéric [Auteur]
Centre de Recherche en Automatique de Nancy [CRAN]
Institut de Cancérologie de Lorraine - Alexis Vautrin [Nancy] [UNICANCER/ICL]
Barabino, Gabriele [Auteur]
Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] [CHU ST-E]
Thomas, Pascal-Alexandre [Auteur]
Departement de chirurgie thoracique et des maladies de l'oesophage [Hôpital Nord - APHM]
Piessen, Guillaume [Auteur]
Hôpital Claude Huriez [Lille]
Hétérogénéité, Plasticité et Résistance aux Thérapies des Cancers = Cancer Heterogeneity, Plasticity and Resistance to Therapies - UMR 9020 - U 1277 [CANTHER]
D’journo, Xavier-Benoît [Auteur correspondant]
Departement de chirurgie thoracique et des maladies de l'oesophage [Hôpital Nord - APHM]

Journal title :

European Journal of Cardio-Thoracic Surgery

Pages :

1104-1112

Publisher :

Oxford University Press (OUP)

Publication date :

2019-06-01

ISSN :

1010-7940

HAL domain(s) :

Sciences du Vivant [q-bio]/Cancer

English abstract : [en]

OBJECTIVES: Hiatal hernias (HH) after oesophagectomy are rare, and their surgical management is not well standardized. Our goal was to report on the management of HH after oesophagectomy in high-volume tertiary European ...
Show more >OBJECTIVES: Hiatal hernias (HH) after oesophagectomy are rare, and their surgical management is not well standardized. Our goal was to report on the management of HH after oesophagectomy in high-volume tertiary European French-speaking centres.METHODS: We conducted a retrospective multicentre study among 19 European French-speaking departments of upper gastrointestinal and/or thoracic surgery. All patients scheduled or operated on for the repair of an HH after oesophagectomy were collected between 2000 and 2016. Demographics, details of the initial procedure, surgical management and long-term outcome were analysed.RESULTS: Seventy-nine of 6608 (1.2%) patients who had oesophagectomies were included in the study. The postoesophagectomy diagnostic interval of an HH after oesophagectomy was ≤90 days (n = 17; 21%), 13 were emergency cases; between 91 days and 1 year, n = 21 (27%), 13 in emergency; ≥1 year, n = 41 (52%), 17 in emergency. The time to occurrence of HH after oesophagectomy was shorter after laparoscopy (median 308 days; interquartile range 150–693) compared to that after laparotomy (median 562 days, interquartile range 138–1768; P = 0.01). The incidence of HH after oesophagectomy was 0.73% (22/3010) after open surgery and 1.4% (26/1761) after laparoscopy (P = 0.03). Among the 79 patients, 78 were operated on: 35 had laparotomies (45%), 19 had laparoscopies (24%) and 24 (31%) had transthoracic approaches. Among the 43 urgent surgeries, 35 were open (25 laparotomies and 10 transthoracic approaches) and 8 were laparoscopies (conversion rate, 25%). Nine patients required bowel resections. Morbidity occurred in 36 (46%) patients with 1 postoperative death (1.2%). During the follow-up period, recurrent HH after oesophagectomy requiring revisional surgery developed in 8 (6 days–26 months) patients.CONCLUSIONS: Surgical management of HH after oesophagectomy could be done by laparoscopy in patients with scheduled surgery but laparotomy or thoracotomy was preferred in urgent situations. The incidence of HH after oesophagectomy is higher and its onset earlier when laparoscopy is used at the initial oesophagectomy.Show less >

Language :

Anglais

Popular science :

Non

Collections :

• Cancer Heterogeneity, Plasticity and Resistance to Therapies (CANTHER) - UMR 9020 - UMR 1277

Source :

Harvested from HAL