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急诊情况下微创食管切除术后的副通道食管裂孔疝

Paraconduit hiatal hernia following minimally invasive oesophagectomy in an emergent setting.

作者信息

Teng Thomas Zheng Jie, Oo Aung Myint, Tay Kon Voi

机构信息

Undergraduate Medicine, Lee Kong Chian School of Medicine, NTU Singapore, 11 Mandalay Road, Singapore, 308207 Singapore.

Department of General Surgery, Tan Tock Seng Hospital, Singapore, Singapore.

出版信息

Indian J Thorac Cardiovasc Surg. 2022 Jul;38(4):445-447. doi: 10.1007/s12055-022-01359-6. Epub 2022 May 13.

Abstract

Paraconduit hiatal hernia (PHH) remains a rare complication from oesophagectomies. Although minimally invasive oesophagectomies (MIO) for oesophageal cancer offer many advantages over open oesophagectomies (OO), the incidence of PHH appears to buckle this trend. As such, there is paucity in the current literature on the preferred approach as well as the management of PHH post-MIO. We present 2 emergent cases of post-MIO PHH. The laparoscopic approach of PHH repair appears feasible and safe even in the emergent setting. However, most advocate for the avoidance of emergent surgery altogether by astute care and prevention of PHH formation, or with early repair, if found asymptomatic PHH during surveillance scan.

摘要

食管旁裂孔疝(PHH)仍然是食管切除术罕见的并发症。尽管用于治疗食管癌的微创食管切除术(MIO)相比开放食管切除术(OO)具有许多优势,但PHH的发生率似乎扭转了这一趋势。因此,目前关于MIO后PHH的首选治疗方法及管理的文献较少。我们报告2例MIO后PHH的急诊病例。即使在急诊情况下,腹腔镜修补PHH的方法似乎也是可行且安全的。然而,大多数人主张通过精心护理和预防PHH形成来完全避免急诊手术,或者如果在监测扫描中发现无症状的PHH,则进行早期修复。

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