2019 Volume 39 Issue 1 Pages 109-112
Case 1 was a 74-year-old man. One year eleven months after thoracoscopic esophageal surgery for esophageal cancer and open gastric tube reconstruction via the posterior mediastinal route, he visited our hospital complaining of abdominal pain. Abdominal plain X-ray and CT revealed incarceration of the small intestine in the left thoracic cavity. We diagnosed esophageal hiatal hernia, reduced the small intestine laparoscopically, and sutured the hiatus. Case 2 was a 79-year-old man. He had undergone thoracoscopic esophageal surgery for esophageal cancer and laparoscopic gastric tube reconstruction via the posterior mediastinal route. Two months after the surgery, he presented with the complaints of chest pain, dyspnea and melena. Imaging examination revealed prolapse of the transverse colon into the left thoracic cavity. We sutured the hiatus and fixed the gastric tube laparoscopically. Diaphragmatic hernia after esophageal surgery for esophageal cancer is relatively rare, but there is a certain risk of its being severe, even if it is asymptomatic, and it must be regarded as an indication of surgery. Laparoscopic repair of hiatal hernia after esophageal cancer surgery has been reported previously in only 8 cases in Japan. Laparoscopic repair is a useful procedure for hiatal hernia owing to its minimally invasive nature and ease of securing an adequate surgical field.
