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• W4386508919 abstract "Objectives We hypothesized that emergency complications related to asymptomatic paraconduit hernias may occur less often than generally believed. Therefore, we assessed the occurrence and timing of paraconduit hernia diagnosis following esophagectomy, as well as outcomes of these asymptomatic patients managed with a watch-and-wait approach. Methods From 2006–2021, 1214 patients underwent esophagectomy with reconstruction at Cleveland Clinic. Among these patients, computed tomography scans were reviewed to identify paraconduit hernias. Medical records were reviewed for timing of hernia diagnosis, hernia characteristics, and patient symptoms, complications, and management. During this period, patients with asymptomatic paraconduit hernias were typically managed non-operatively. Results Paraconduit hernias were identified in 37 patients. Of these, 31 (84%) had a pre-esophagectomy hiatal hernia. Twenty-one (57%) hernias contained colon, 7 (19%) pancreas, and 9 (24%) multiple organs. Estimated prevalence of paraconduit hernia was 3.3% at 3 years and 7.7% at 10 years. Seven (19%) had symptoms, four of whom were repaired electively, with two currently awaiting repairs. No patient with a paraconduit hernia experienced an acute complication that required emergency intervention. Conclusions The risk of paraconduit hernia increases with time, suggesting that long-term symptom surveillance is reasonable. Emergency complications as a result of asymptomatic paraconduit hernias are rare. A small number of patients will experience hernia-related symptoms, sometimes years after hernia diagnosis. Our findings suggest that observation of asymptomatic paraconduit hernias (watch-and-wait) may be considered, with repair considered electively in patients with persistent symptoms." @default.
• W4386508919 created "2023-09-08" @default.
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• W4386508919 date "2023-09-01" @default.
• W4386508919 modified "2023-10-02" @default.
• W4386508919 title "Paraconduit Hernia Following Esophagectomy: Is it Safe to Watch-and-Wait?" @default.
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• W4386508919 doi "https://doi.org/10.1016/j.jtcvs.2023.08.041" @default.
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