Dataset Information

Surgical management of delayed-presentation diaphragm hernia: A single-institution experience.

ABSTRACT:

Objectives

Delayed-presentation diaphragm hernias are uncommon, and surgical management varies widely across practices. We describe our surgical experience with delayed-presentation diaphragm hernias as a case series of 14 patients, 9 of whom underwent minimally invasive repair.

Methods

We performed a retrospective chart review of our prospective database of all patients treated surgically for delayed-presentation diaphragm hernia at our institution from January 1, 2005, to April 30, 2021. We excluded patients with poststernotomy, post-left ventricular assist device, and previously diagnosed congenital hernias. We recorded patient demographics, etiology, laterality, chronicity, operative details, postoperative complications, and long-term results.

Results

We performed surgical repair of delayed-presentation diaphragm hernia in 14 patients. Eleven patients (79%) were male, the median age was 61 (18-83) years, the median body mass index was 29.2 (14.5-33.7), and 8 (57%) hernias were left-sided. Etiology was trauma (n = 7, 50%), iatrogenic (n = 5, 36%), and unknown (n = 2, 14%). Median time to presentation in patients with traumatic and iatrogenic hernias was 7.5 years (6 weeks to 38 years). Nine patients (64%) underwent minimally invasive repair, and 5 patients (36%) underwent open repair. We used a synthetic patch in all but 2 patients (86%). Median length of stay was 5 (3-27) days. Two patients (14%) had major complications. There were no deaths. Twelve patients (86%) had follow-up imaging at a median follow-up of 17 months (1-192) with zero recurrences.

Conclusions

Our experience suggests that a minimally invasive or an open approach to patients with a delayed-presentation diaphragm hernia is safe and effective. We recommend tailoring the surgical approach based on patient characteristics, anatomic considerations, and surgeons' experience.

SUBMITTER: Jones EK

PROVIDER: S-EPMC9197083 | biostudies-literature | 2022 Jun

REPOSITORIES: biostudies-literature

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Publications

Surgical management of delayed-presentation diaphragm hernia: A single-institution experience.

Jones Emma K EK Andrade Rafael R Bhargava Amit A Diaz-Gutierrez Ilitch I Rao Madhuri M

JTCVS techniques 20220420

<h4>Objectives</h4>Delayed-presentation diaphragm hernias are uncommon, and surgical management varies widely across practices. We describe our surgical experience with delayed-presentation diaphragm hernias as a case series of 14 patients, 9 of whom underwent minimally invasive repair.<h4>Methods</h4>We performed a retrospective chart review of our prospective database of all patients treated surgically for delayed-presentation diaphragm hernia at our institution from January 1, 2005, to April ...[more]

PMID: 35711179

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Dataset Information

Surgical management of delayed-presentation diaphragm hernia: A single-institution experience.

Objectives

Methods

Results

Conclusions

Publications

Surgical management of delayed-presentation diaphragm hernia: A single-institution experience.

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