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Postesophagectomy Diaphragmatic Prolapse after Robot-Assisted Minimally Invasive Esophagectomy (RAMIE)
被引:2
|作者:
Brunner, Stefanie
[1
]
Mueller, Dolores T.
[1
]
Eckhoff, Jennifer A.
[1
]
Lange, Valentin
[2
]
Chon, Seung-Hun
[1
]
Schmidt, Thomas
[1
]
Schroeder, Wolfgang
[1
]
Bruns, Christiane J.
[1
]
Fuchs, Hans F.
[1
]
机构:
[1] Univ Hosp Cologne, Dept Gen Visceral Canc & Transplantat Surg, D-50937 Cologne, Germany
[2] Univ Cologne, Fac Med, D-50923 Cologne, Germany
关键词:
esophagectomy;
IL-RAMIE;
esophageal cancer;
postesophagectomy diaphragmatic prolapse;
HIATAL-HERNIA;
OPEN-LABEL;
MULTICENTER;
EXPERIENCE;
CANCER;
REPAIR;
D O I:
10.3390/jcm12186046
中图分类号:
R5 [内科学];
学科分类号:
1002 ;
100201 ;
摘要:
Background: Postesophagectomy diaphragmatic prolapse (PDP) is a major complication after esophagectomy with significant mortality and morbidity. However, in the current literature, treatment and outcomes are not evaluated for patients undergoing an Ivor Lewis Robot-assisted minimally invasive esophagectomy (IL-RAMIE). The aim of this study is to evaluate the incidence of PDP after IL-RAMIE. Moreover, the study aims to determine whether using a minimally invasive approach in the management of PDP after an IL-RAMIE procedure is safe and feasible. Materials and Methods: This study includes all patients who received an IL-RAMIE at our high-volume center (>200 esophagectomies/year) between April 2017 and December 2022 and developed PDP. The analysis focuses on time to prolapse, symptoms, treatment, surgical method, and recurrence rates of these patients. Results: A total of 185 patients underwent an IL-RAMIE at our hospital. Eleven patients (5.9%) developed PDP. Patients presented with PDP after a medium time of 241 days with symptoms like reflux, nausea, vomiting, and pain. One-third of these patients did not suffer from any symptoms. In all cases, a CT scan was performed in which the colon transversum always presented as the herniated organ. In one patient, prolapse of the small intestine, pancreas, and greater omentum also occurred. A total of 91% of these patients received a revisional surgery in a minimally invasive manner with a mean hospital stay of 12 days. In four patients, PDP recurred (36%) after 13, 114, 119 and 237 days, respectively. Conclusion: This study shows that a minimally invasive approach in repositioning PDP is a safe and effective option after IL-RAMIE.
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