Our Summary

The research paper is about a study conducted to determine how often a specific type of hernia (post-esophagectomy hiatal hernia or PEHH) develops after a particular surgery (transhiatal esophagectomy). This type of hernia is rare and can cause problems, but can sometimes occur after surgery on the esophagus (the tube that connects your throat to your stomach). The researchers looked at medical records from 2012 to 2020, and collected data on the patients, the surgeries, and the occurrence of these hernias. Out of 160 surgeries, four patients developed this type of hernia, usually about a year after surgery. Three of these patients had symptoms that led to the diagnosis. The researchers note that their study is small, so they can’t make any strong conclusions about risk factors or the best way to fix the hernia. They also suggest that the actual incidence of this hernia could be higher than reported because some patients may not have noticeable symptoms.

FAQs

  1. What is the prevalence of post-esophagectomy hiatal hernia according to the study?
  2. How long after surgery did patients in the study typically develop a post-esophagectomy hiatal hernia?
  3. Were any risk factors or repair methods identified in this study for post-esophagectomy hiatal hernias?

Doctor’s Tip

A helpful tip a doctor might tell a patient about esophagectomy is to be aware of the possibility of developing a post-esophagectomy hiatal hernia (PEHH) and to watch for symptoms such as difficulty swallowing, chest pain, or acid reflux. It is important to communicate any new or worsening symptoms to your healthcare provider promptly to ensure timely diagnosis and treatment if needed.

Suitable For

Patients who are typically recommended for esophagectomy include those with esophageal cancer, Barrett’s esophagus with high-grade dysplasia, severe gastroesophageal reflux disease (GERD) that is not responsive to medical management, and other esophageal disorders such as achalasia or esophageal strictures. Additionally, patients who have failed previous endoscopic or surgical interventions may also be candidates for esophagectomy.

Timeline

Before esophagectomy:

  • Patient is diagnosed with a condition requiring esophagectomy, such as esophageal cancer or Barrett’s esophagus.
  • Patient undergoes preoperative assessments, including imaging studies and consultations with various medical specialists.
  • Patient may undergo neoadjuvant therapy, such as chemotherapy or radiation, to shrink the tumor before surgery.
  • Patient undergoes the esophagectomy procedure, which can be performed through various techniques, such as transhiatal or transthoracic approaches.

After esophagectomy:

  • Patient experiences postoperative recovery, which may involve a hospital stay of several days to weeks.
  • Patient undergoes postoperative follow-up appointments to monitor for complications and adjust treatment as needed.
  • Patient may experience long-term complications, such as post-esophagectomy hiatal hernia (PEHH), which can occur months to years after the surgery.
  • If PEHH develops, patient may undergo repair surgery to address the hernia and alleviate symptoms.
  • Patient continues to undergo regular monitoring and follow-up care to manage any ongoing issues related to the esophagectomy.

What to Ask Your Doctor

  1. What is the risk of developing a post-esophagectomy hiatal hernia (PEHH) after the surgery?
  2. What are the symptoms of a PEHH and how soon after surgery should I be concerned about them?
  3. How is a PEHH diagnosed and what tests may be needed?
  4. What are the treatment options for a PEHH and when would surgery be necessary?
  5. Are there any specific lifestyle changes or precautions I should take to reduce my risk of developing a PEHH?
  6. How often should I follow up with you after the esophagectomy to monitor for any potential complications, including a PEHH?
  7. Are there any specific factors in my medical history or the details of my surgery that may increase my risk of developing a PEHH?
  8. How will the presence of a PEHH impact my long-term recovery and overall health after the esophagectomy?
  9. Are there any support groups or resources available for patients who have undergone an esophagectomy and may be at risk for developing a PEHH?
  10. Are there any ongoing research studies or clinical trials related to PEHH that I should be aware of?

Reference

Authors: Benzie AL, Darwish MB, Basta A, McLaren PJ, Cho EE, Osman H, Jay J, Jeyarajah DR. Journal: Am Surg. 2023 Jun;89(6):2820-2823. doi: 10.1177/00031348211054546. Epub 2021 Nov 19. PMID: 34797195