UNASSIGNED: The study objective was to determine the relationship between lung resection and the development of postoperative hiatal hernia.
UNASSIGNED: Preoperative and postoperative computed tomography imaging from 373 patients from the International Early Lung Cancer Action Program and the Initiative for Early Lung Cancer Research on Treatment were compared at a median of 31.1 months of follow-up after resection of clinical early-stage non-small cell lung cancer. Incidence of new hiatal hernia or changes to preexisting hernias were recorded and evaluated by patient demographics, surgical approach, extent of resection, and resection site.
UNASSIGNED: New hiatal hernias were seen in 9.6% of patients after lung resection (5.6% after wedge or segmentectomy and 12.4% after lobectomy; P = .047). The median size of new hernias was 21 mm, and the most commonly associated resection site was the left lower lobe (24.2%; P = .04). In patients with preexisting hernias, 53.5% demonstrated a small but significant increase in size from 21 to 22 mm (P < .0001). All hernias persisted through the latest postoperative computed tomography scan. When 110 surgical patients without preexisting hernia were matched by sex, age, and smoking to nonoperative controls, the incidence of new hernia at follow-up was significantly higher among those who underwent surgery (17.3% vs 2.7%, P = .0003).
UNASSIGNED: Both open and minimally invasive lung resection for clinical early-stage lung cancer are associated with new or enlarging postoperative hiatal hernia, especially after resections involving the left lower lobe.

Laparoscopic repair of large paraesophageal hiatal hernia with defects too large to close primarily or greater than 8 cm is technically challenging. The ideal repair remains unclear and is often debated. Utilizing the gastric fundus as an autologous patch to obliterate and tamponade large hiatal defects may offer a new solution. The aim of this study was to evaluate the short-term outcomes following partial posterior fundoplication with gastric fundus tamponade.
Retrospective chart review and prospective patient follow up was conducted on patients who underwent laparoscopic hiatal hernia repair between 2015 and 2019 by a single surgeon. Basic demographics, pre-operative diagnoses, operative technique, and clinical outcomes were recorded.
Fifteen patients underwent the described technique for repair of large paraesophageal hiatal hernia. All procedures were completed laparoscopically with a short post-operative length of stay (mean of 3 days) and no 30-day readmissions. The majority of patients reported resolution of their pre-operative symptoms. Only one patient required surgery for emergent indications and the same patient was the only mortality in the study, which was secondary to respiratory failure, necrotizing pneumonia, and sepsis as a result of gastric volvulus and obstruction.
Utilizing the gastric fundus as an autologous patch to repair large hiatal hernia may be a safe and efficacious solution with good short-term outcomes. However, further studies should be conducted to elucidate long-term results.

BACKGROUND: Primary repair of large hiatal hernia is associated with a high recurrence rate, which has led to the use of mesh for crural repair. However, severe mesh-related complications, including esophageal or gastric erosion, have been observed.
METHODS: In the present study, we made a thorough identification of all published reports on the esophageal or gastric mesh erosion or migration after hiatal hernia repair. The incidence, site, mesh type, latent interval, consequence and treatment methods of mesh erosion were summarized and analyzed.
RESULTS: A total of 50 cases of esophageal or gastric mesh erosion or migration after hiatal hernia repair were reported since 1998. A higher erosion rate was observed in recurrent hiatal hernia repair. The most common erosion site was esophagus (50%), followed by stomach (25%) and gastric-esophageal junction (GEJ) (23%). The most common mesh types reported in this series were PTEF and polypropylene. The duration from the hernia repair to the identification of erosion varied greatly, and 79% of the erosion occurred within 2 years after the hernia repair. Various treatment methods were reported, including endoscopic mesh retrieval (15.7%), laparoscopic mesh removal (11.8%), surgical mesh removal (19.6%); however, distal esophageal resection and gastric resection were reported in 19.6% and 5.9%, respectively. Some patients had to receive tube feeding.
CONCLUSIONS: The true incidence of mesh erosion after hiatal hernia repair may be higher than previously reported, and the erosion is more prone to occur after recurrent hiatal hernia repair. Mesh erosion can result in severe morbidity and sometimes require complex organ resection. Different kinds and shapes of prosthetic meshes can cause erosion; therefore, mesh should be used very selectively for hiatal hernia repair. The patient should be informed about the mesh placement and the possible mesh-related complications.

UNASSIGNED: Increasing evidence suggests that kyphoscoliosis may play a role in the pathophysiology of paraesophageal hernia development. The presence of severe kyphoscoliosis not only increases the incidence of paraesophageal hernia but also increases the risk of hiatal hernia (HH) repair. Moreover, the technical skills and the pitfalls of laparoscopic repair of HH in this special condition have yet been described.
UNASSIGNED: The technical skills, experience and pitfalls of laparoscopic paraesophageal hernia repair in severe kyphoscoliosis patients were described. These include perioperative care of patients\' pulmonary function, patients\' operating position and trocar placement, and the key steps and risks of laparoscopic HH repair in this special condition.
UNASSIGNED: Paraesophageal HHs were successfully laparoscopically repaired, and prolonged hospital stay was due to post-operative pulmonary complications.
UNASSIGNED: These techniques are essential to minimise the perioperative complications in laparoscopic paraesophageal hernia repair in severe kyphoscoliosis patients, and great pulmonary care is required in these patients.