JTCVS Open (Jun 2022)

New or enlarging hiatal hernias after thoracic surgery for early lung cancerCentral MessagePerspective

  • Kimberly J. Song, MD,
  • Rowena Yip, MPH,
  • Michael Chung, MD,
  • Qiang Cai, MD, PhD,
  • Yeqing Zhu, MD, PhD,
  • Ayushi Singh, MD,
  • Erik E. Lewis, MD,
  • David Yankelevitz, MD,
  • Emanuela Taioli, MD, PhD,
  • Claudia Henschke, MD, PhD,
  • Raja Flores, MD,
  • Raja Flores, MD,
  • Andrew Kaufman, MD,
  • Dong-Seok Lee, MD,
  • Daniel Nicastri, MD,
  • Andrea Wolf, MD,
  • Kimberly Song, MD,
  • Kenneth Rosenzweig, MD,
  • Jorge Gomez, MD,
  • Mary Beth Beasley, MD,
  • Maureen Zakowski, MD,
  • Michael Chung, MD,
  • David F. Yankelevitz, MD,
  • Claudia I. Henschke, PhD, MD,
  • Emanuela Taioli, MD, PhD,
  • Rebecca Schwartz, MD,
  • Huiwen Chan,
  • Jeffrey Zhu,
  • Sydney Kantor,
  • Shana Adler,
  • Daniel Nicastri, MD,
  • Wissam Raad, MD,
  • Zrzu Buyuk, MD,
  • Adie Friedman, MD,
  • Ronald Dreifuss, MD,
  • Stacey Verzosa, MD,
  • Mariya Yakubox, NP,
  • Karina Aloferdova, NP,
  • Patricia Stacey,
  • Simone De Nobrega,
  • Jeffrey Zhu,
  • Sydney Kantor,
  • Shana Adler,
  • Ardeshir Hakami, MD,
  • Shana Adler,
  • Jeffrey Zhu,
  • Harvey Pass, MD,
  • Berne Crawford, MD,
  • Jessica Donnington, MD,
  • Benjamin Cooper, MD,
  • Andre Moreirea, MD,
  • Audrey Sorensen, RN,
  • Leslie Kohman, MD,
  • Robert Dunton, MD,
  • Jason Wallen, MD,
  • Christopher Curtiss, MD,
  • Ernest Scalzetti, MD,
  • Linda Ellinwood, RN,
  • Clifford P. Connery, MD,
  • Emilo Torres, MD,
  • Dan Cruzer, MD,
  • Bruce Gendron, MD,
  • Sonya Alyea, NP,
  • Daniel Lackaye,
  • Lauren Studer,
  • Raja Flores, MD,
  • Claudia Henschke, PhD, MD,
  • Emanuela Taioli, MD, PhD,
  • David Yankelevitz, MD,
  • Rebecca Schwartz, PhD,
  • Betsy Becker, PhD,
  • Artit Jirapatnakul, PhD,
  • Rowena Yip, MPH,
  • Nan You, MS,
  • Huiwen Chan, MPH, MBA,
  • Claudia I. Henschke,
  • David F. Yankelevitz,
  • Rowena Yip,
  • Artit Jirapatnakul,
  • Raja Flores,
  • Andrea Wolf,
  • Daniel M. Libby,
  • James P. Smith,
  • Mark Pasmantier,
  • A.P. Reeves,
  • Steven Markowitz,
  • Albert Miller,
  • Jose Cervera Deval,
  • Heidi Roberts,
  • Demetris Patsios,
  • Shusuke Sone,
  • Takaomi Hanaoka,
  • Javier Zulueta,
  • Juan P. de-Torres,
  • Maria D. Lozano,
  • Ralph Aye,
  • Kristin Manning,
  • Christiana Care,
  • Thomas Bauer,
  • Stefano Canitano,
  • Salvatore Giunta,
  • Enser Cole,
  • Karl Klingler,
  • John H.M. Austin,
  • Gregory D.N. Pearson,
  • Dorith Shaham,
  • Cheryl Aylesworth,
  • Patrick Meyers,
  • Shahriyour Andaz,
  • Davood Vafai,
  • David Naidich,
  • Georgeann McGuinness,
  • Barry Sheppard,
  • Matthew Rifkin,
  • M. Kristin Thorsen,
  • Richard Hansen,
  • Samuel Kopel,
  • William Mayfield,
  • Dan Luedke,
  • Donald Klippenstein,
  • Alan Litwin,
  • Peter A. Loud,
  • Leslie J. Kohman,
  • Ernest M. Scalzetti,
  • Richard Thurer,
  • Nestor Villamizar,
  • Arfa Khan,
  • Rakesh Shah,
  • Xueguo Liu,
  • Gary Herzog,
  • Diana Yeh,
  • Ning Wu,
  • Joseph Lowry,
  • Mary Salvatore,
  • Carmine Frumiento,
  • David S. Mendelson,
  • Michael V. Smith,
  • Robert Korst,
  • Jana Taylor,
  • Michelle S. Ginsberg,
  • Michaela Straznicka,
  • Mark Widmann,
  • Gary Cecchi,
  • Terence A.S. Matalon,
  • Paul Scheinberg,
  • Shari-Lynn Odzer,
  • David Olsen,
  • Fred Grannis,
  • Arnold Rotter,
  • Daniel Ray,
  • David Mullen,
  • Peter H. Wiernik,
  • Edson H. Cheung,
  • Melissa Lim,
  • Louis DeCunzo,
  • Robert Glassberg,
  • Harvey Pass,
  • Carmen Endress,
  • Mark Yoder,
  • Palmi Shah,
  • Laura Welch,
  • Michael Kalafer,
  • Jeremy Green,
  • James Walsh,
  • David Bertsch,
  • Elmer Camacho,
  • Cynthia Chin,
  • James O'Brien,
  • James C. Willey,
  • Claudia I. Henschke,
  • David F. Yankelevitz,
  • Rowena Yip,
  • Artit Jirapatnakul,
  • Raja Flores,
  • Andrea Wolf,
  • Daniel M. Libby,
  • James P. Smith,
  • Mark Pasmantier,
  • A.P. Reeves,
  • Steven Markowitz,
  • Albert Miller,
  • Jose Cervera Deval,
  • Heidi Roberts,
  • Demetris Patsios,
  • Shusuke Sone,
  • Takaomi Hanaoka,
  • Javier Zulueta,
  • Juan P. de-Torres,
  • Maria D. Lozano,
  • Ralph Aye,
  • Kristin Manning,
  • Thomas Bauer,
  • Stefano Canitano,
  • Salvatore Giunta,
  • Enser Cole,
  • Karl Klingler,
  • John H.M. Austin,
  • Gregory D.N. Pearson,
  • Dorith Shaham,
  • Cheryl Aylesworth,
  • Patrick Meyers,
  • Shahriyour Andaz,
  • Davood Vafai,
  • David Naidich,
  • Georgeann McGuinness,
  • Barry Sheppard,
  • Matthew Rifkin,
  • M. Kristin Thorsen,
  • Richard Hansen,
  • Samuel Kopel,
  • William Mayfield,
  • Dan Luedke,
  • Donald Klippenstein,
  • Alan Litwin,
  • Peter A. Loud,
  • Leslie J. Kohman,
  • Ernest M. Scalzetti,
  • Richard Thurer,
  • Nestor Villamizar,
  • Arfa Khan,
  • Rakesh Shah,
  • Xueguo Liu,
  • Gary Herzog,
  • Diana Yeh,
  • Ning Wu,
  • Joseph Lowry,
  • Mary Salvatore,
  • Carmine Frumiento,
  • David S. Mendelson,
  • Michael V. Smith,
  • Robert Korst,
  • Jana Taylor,
  • Michelle S. Ginsberg,
  • Michaela Straznicka,
  • Mark Widmann,
  • Gary Cecchi,
  • Terence A.S. Matalon,
  • Paul Scheinberg,
  • Shari-Lynn Odzer,
  • David Olsen,
  • Fred Grannis,
  • Arnold Rotter,
  • Daniel Ray,
  • David Mullen,
  • Peter H. Wiernik,
  • Edson H. Cheung,
  • Melissa Lim,
  • Louis DeCunzo,
  • Robert Glassberg,
  • Harvey Pass,
  • Carmen Endress,
  • Mark Yoder,
  • Palmi Shah,
  • Laura Welch,
  • Michael Kalafer,
  • James Walsh,
  • David Bertsch,
  • Elmer Camacho,
  • Cynthia Chin,
  • James C. Willey

Journal volume & issue
Vol. 10
pp. 415 – 423

Abstract

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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.

Keywords