PDF(Pubmed)
Abstract：
UNASSIGNED: Minimally invasive esophagectomy has emerged as the established standard for treating esophageal cancer. The gastric graft is usually placed in the posterior mediastinum or the retrosternal tunnel for reconstruction. Hiatal hernia occurrence is more common in the posterior mediastinal reconstruction and is more frequently observed in laparoscopic compared to open approach. On the other hand, retrosternal hernia is a rare complication that deserves greater attention, considering the increasing popularity of retrosternal reconstruction in esophageal cancer treatment.
METHODS: We present the case of a 55-year-old male patient who underwent minimally invasive esophagectomy with retrosternal reconstruction using gastric conduit and cervical anastomosis. After four years, the patient experienced symptoms, including dyspnea and chest pain. CT scan revealed transverse colon herniation into the retrosternal tunnel.
UNASSIGNED: Our diagnosis was retrosternal herniation of the transverse colon. Although there was no sign of obstruction, the abundant colon in the retrosternal space caused mass effect symptoms. For that reason, we performed laparoscopic surgery to release the herniated organ and close the hernia hole. Postoperatively, the patient had a satisfactory recovery, and a follow-up CT scan confirmed the absence of any remaining herniated organs.
CONCLUSIONS: While hiatal hernia is a well-known complication in minimally invasive esophagectomy, retrosternal hernia is a lesser-known entity. Surgical intervention is necessary to alleviate symptoms caused by herniation or address complications such as strangulation. The occurrence of retrosternal hernia warrants further attention and research in the future.
METHODS: We present the case of a 55-year-old male patient who underwent minimally invasive esophagectomy with retrosternal reconstruction using gastric conduit and cervical anastomosis. After four years, the patient experienced symptoms, including dyspnea and chest pain. CT scan revealed transverse colon herniation into the retrosternal tunnel.
UNASSIGNED: Our diagnosis was retrosternal herniation of the transverse colon. Although there was no sign of obstruction, the abundant colon in the retrosternal space caused mass effect symptoms. For that reason, we performed laparoscopic surgery to release the herniated organ and close the hernia hole. Postoperatively, the patient had a satisfactory recovery, and a follow-up CT scan confirmed the absence of any remaining herniated organs.
CONCLUSIONS: While hiatal hernia is a well-known complication in minimally invasive esophagectomy, retrosternal hernia is a lesser-known entity. Surgical intervention is necessary to alleviate symptoms caused by herniation or address complications such as strangulation. The occurrence of retrosternal hernia warrants further attention and research in the future.
摘要：
■微创食管切除术已成为治疗食管癌的既定标准。胃移植物通常放置在后纵隔或胸骨后隧道中进行重建。与开放入路相比，食管裂孔疝的发生在后纵隔重建中更为常见，并且在腹腔镜中更常见。另一方面,胸骨后疝是一种罕见的并发症，值得更多关注，考虑到胸骨后重建在食管癌治疗中的日益普及。
方法：我们介绍了一例55岁的男性患者，该患者采用胃导管和颈部吻合术进行了微创食管切除术和胸骨后重建。四年后,患者出现症状,包括呼吸困难和胸痛。CT扫描显示横结肠疝进入胸骨后隧道。
■我们的诊断是横结肠胸骨后疝。虽然没有阻塞的迹象,大量结肠在胸骨后间隙引起肿块效应症状。出于这个原因,我们进行了腹腔镜手术以释放疝器官并关闭疝孔。术后,病人恢复得令人满意，和后续CT扫描证实没有任何剩余的疝器官。
结论：虽然食管裂孔疝是众所周知的微创食管切除术的并发症，胸骨后疝是一个鲜为人知的实体。手术干预对于减轻由疝引起的症状或解决诸如绞窄的并发症是必要的。胸骨后疝的发生值得进一步关注和研究。
方法：我们介绍了一例55岁的男性患者，该患者采用胃导管和颈部吻合术进行了微创食管切除术和胸骨后重建。四年后,患者出现症状,包括呼吸困难和胸痛。CT扫描显示横结肠疝进入胸骨后隧道。
■我们的诊断是横结肠胸骨后疝。虽然没有阻塞的迹象,大量结肠在胸骨后间隙引起肿块效应症状。出于这个原因,我们进行了腹腔镜手术以释放疝器官并关闭疝孔。术后,病人恢复得令人满意，和后续CT扫描证实没有任何剩余的疝器官。
结论：虽然食管裂孔疝是众所周知的微创食管切除术的并发症，胸骨后疝是一个鲜为人知的实体。手术干预对于减轻由疝引起的症状或解决诸如绞窄的并发症是必要的。胸骨后疝的发生值得进一步关注和研究。
