BACKGROUND: The uptake of minimally invasive oesophagectomy (MIO) in the UK has increased dramatically in recent years. Post-oesophagectomy diaphragmatic @entity547 (PODHs) are rare, but may be influenced by the type of approach to resection. The aim of this study was to compare the incidence of symptomatic PODH following open and MIO in a UK specialist centre. METHODS: Consecutive @entity1 undergoing oesophagectomy for @entity5 between 1996 and 2012 were included. A standardised, radical approach to the abdominal phase was employed, irrespective of the type of procedure undertaken. @entity1 demographics, details of surgery and post-operative complications were collected from @entity1 records and a prospective database. RESULTS: A total of 273 oesophagectomies were performed (205 open; 68 MIO). There were 62 hybrid MIOs (laparoscopic abdomen and thoracotomy) and six total MIOs. Seven @entity1 required conversion and were analysed as part of the open cohort. Nine @entity1 (13.2  %) developed a PODH in the MIO cohort compared with two @entity1 (1.0  %) in the open cohort, (p  <  0.001). Five @entity1 developed @entity547 in the early post-operative period (days 2-10): all following MIO. Both PODHs in the open cohort occurred following transhiatal oesophagectomy. All PODHs were symptomatic and required surgical repair. CT thorax confirmed the diagnosis in 10 @entity1 . Seven @entity547 were repaired laparoscopically, including two cases in the early post-operative period. PODHs were repaired using the following techniques: suture (n  =  6), mesh reinforcement (n  =  4) and omentopexy to the anterior abdominal wall without hiatal closure (n  =  1). There were two recurrences (18  %). CONCLUSIONS: The incidence of symptomatic PODH may be higher following MIO compared to open surgery. The reasons for this are unclear and may not be completely explained by the reduction in adhesion formation. Strategies such as fixation of the conduit to the diaphragm and omentopexy to the abdominal wall may reduce the incidence of @entity3976 .

Symptomatic diaphragmatic XXXX following open and minimally invasive oesophagectomy: experience from a UK specialist unit.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient', 'Patient'] @entity3976 :: ('MESH:D004677', 'Disease') :: ['herniation'] @entity5 :: ('MESH:D009369', 'Disease') :: ['malignant disease'] @entity547 :: ('MESH:D006547', 'Disease') :: ['hernias']
@entity3976 :: (MESH:D004677,Disease) :: ['herniation']
