Diaphragmatic Herniation after Transthoracic Esophagectomy for Esophageal Cancer

Esophageal carcinoma is the sixth leading cause of cancer death in the world [1]. The optimal treatment for resectable esophageal cancer is curative surgery, including transhiatal [2] or transthoracic [3] esophagectomy, accompanied by reconstruction of the digestive conduit. Cases of diaphragmatic herniation (DH) after esophagectomy for esophageal cancer have been previously reported. DH is recognized as a low-risk postoperative complication causing abdominal contents in the large and small intestine to extend into the thoracic cavity via the esophageal hiatus. DH is reported to have a sudden onset and sometimes it leads to a severe postoperative course [4,5]. However, the risk factors and prevention methods have been not completely documented. Hence, we investigated and reported the incidence of DH and the associated risk factors in our institution. In addition, we suggest DH prevention methods after transthoracic esophagectomy.