, Volume 19, Issue 4, pp 635–643 | Cite as

Diaphragmatic hernia post-minimally invasive esophagectomy: a discussion and review of literature

  • G. Benjamin
  • A. Ashfaq
  • Y.-H. Chang
  • K. Harold
  • D. JaroszewskiEmail author
Original Article



Diaphragmatic hernia (DH) after esophagectomy is a known complication which can occur and the incidence may be higher after minimally invasive esophagectomy (MIE). A review of our cases involving post-MIE diaphragmatic hernias and the published literature is presented.


A retrospective review of patients who underwent MIE from November 2006 to January 2013 was performed. An Embase and Pub Med literature search on diaphragmatic hernia post-esophagectomy was conducted from 1990 to 2013 and reviewed.


In total, 120 consecutive patients underwent MIE at our institution. Neoadjuvant chemoradiotherapy had been performed in 71.4 % of patients. The mean age was 65 ± 22 years and 85 % were male. Seven patients (5.8 %) were diagnosed with DH by radiographic imaging with 5 (71.4 %) requiring surgical intervention. Diagnosis was made at a median time of 3.4 months (range 1–45 months) after MIE. One patient recurred after repair and underwent a second repair. There were no related mortalities. In literature review, 11 publications reporting DH were reviewed documenting a total of 4669 esophagectomies, with 756 MIE. The incidence of DH observed was 121 (2.6 %) in all patients and 34 (4.5 %) in MIE. Two studies comparing open versus MIE also reported a higher incidence of DH in MIE.


Post-esophagectomy diaphragmatic hernia can occur and may be underreported. Minimally invasive esophagectomy appears to have a higher incidence of postoperative herniation when compared to traditional, open esophagectomy.


Esophageal cancer Esophagectomy Complications postoperative Diaphragmatic hernia 


Conflict of interest



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Copyright information

© Springer-Verlag France 2015

Authors and Affiliations

  • G. Benjamin
    • 1
  • A. Ashfaq
    • 1
  • Y.-H. Chang
    • 2
  • K. Harold
    • 3
  • D. Jaroszewski
    • 1
    Email author
  1. 1.Division of Cardiothoracic SurgeryMayo Clinic ArizonaPhoenixUSA
  2. 2.Division of Health Sciences ResearchMayo ClinicPhoenixUSA
  3. 3.Division of Minimally Invasive SurgeryMayo ClinicPhoenixUSA

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