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Kimberly J. Song, MD; Ayushi Singh, MD; David Yankelevitz, MD; Emanuela Taioli, MD, PhD; Raja Flores, MD; Andrew Kaufman, MD; Dong-Seok Lee, MD; Daniel Nicastri, MD; Andrea Wolf, MD; Kenneth Rosenzweig, MD; Maureen Zakowski, MD; David F. Yankelevitz, MD; Emanuela Taioli, MD, PhD; Rebecca Schwartz, MD; Huiwen Chan; Jeffrey Zhu; Sydney Kantor; Zrzu Buyuk, MD; Adie Friedman, MD; Ronald Dreifuss, MD; Mariya Yakubox, NP; Patricia Stacey; Simone De Nobrega; Harvey Pass, MD; Jessica Donnington, MD; Benjamin Cooper, MD; Andre Moreirea, MD; Audrey Sorensen, RN; Leslie Kohman, MD; Robert Dunton, MD; Dan Cruzer, MD; Bruce Gendron, MD; Daniel Lackaye; Claudia Henschke, PhD, MD; David Yankelevitz, MD; Artit Jirapatnakul, PhD; Rowena Yip, MPH; Nan You, MS; Artit Jirapatnakul; Raja Flores; Andrea Wolf; Mark Pasmantier; A.P. Reeves; Jose Cervera Deval; Heidi Roberts; Demetris Patsios; Takaomi Hanaoka; Javier Zulueta; Juan P. de-Torres; Ralph Aye; Kristin Manning; Stefano Canitano; Salvatore Giunta; Enser Cole; John H.M. Austin; Gregory D.N. Pearson; Cheryl Aylesworth; Patrick Meyers; Shahriyour Andaz; Davood Vafai; David Naidich; Georgeann McGuinness; Barry Sheppard; Matthew Rifkin; Richard Hansen; Samuel Kopel; William Mayfield; Dan Luedke; Alan Litwin; Leslie J. Kohman; Arfa Khan; Xueguo Liu; Gary Herzog; Ning Wu; Joseph Lowry; Mary Salvatore; David S. Mendelson; Michael V. Smith; Robert Korst; Michelle S. Ginsberg; Michaela Straznicka; Mark Widmann; Paul Scheinberg; David Olsen; David Mullen; Peter H. Wiernik; Edson H. Cheung; Melissa Lim; Louis DeCunzo; Robert Glassberg; Harvey Pass; Carmen Endress; Mark Yoder; Laura Welch; Jeremy Green; James Walsh; David Bertsch; Cynthia Chin; James O'Brien; James C. Willey
JTCVS open, 06/2022, Letnik: 10Journal Article
Objective: The study objective was to determine the relationship between lung resection and the development of postoperative hiatal hernia. Methods: Preoperative and postoperative computed tomography imaging from 373 patients from the International Early Lung Cancer Action Program and the Initiative for Early Lung Cancer Research on Treatment were compared at a median of 31.1 months of follow-up after resection of clinical early-stage non–small cell lung cancer. Incidence of new hiatal hernia or changes to preexisting hernias were recorded and evaluated by patient demographics, surgical approach, extent of resection, and resection site. Results: New hiatal hernias were seen in 9.6% of patients after lung resection (5.6% after wedge or segmentectomy and 12.4% after lobectomy; P = .047). The median size of new hernias was 21 mm, and the most commonly associated resection site was the left lower lobe (24.2%; P = .04). In patients with preexisting hernias, 53.5% demonstrated a small but significant increase in size from 21 to 22 mm (P < .0001). All hernias persisted through the latest postoperative computed tomography scan. When 110 surgical patients without preexisting hernia were matched by sex, age, and smoking to nonoperative controls, the incidence of new hernia at follow-up was significantly higher among those who underwent surgery (17.3% vs 2.7%, P = .0003). Conclusions: Both open and minimally invasive lung resection for clinical early-stage lung cancer are associated with new or enlarging postoperative hiatal hernia, especially after resections involving the left lower lobe.
