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Incidence, Diagnosis and Repair of a Diaphragmatic Hernia Following Hepatic Surgery: A Single Center Analysis of 3107 Consecutive Liver Resections

Diaphragmatic hernia (DH) after a liver resection (LR) is an uncommon but potentially severe complication. In this retrospective study, we aim to share our experience with DH in our hepatic surgery center. We retrospectively analyzed 3107 patients who underwent a liver resection between January 2012...

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Autores principales: Raakow, Jonas, Megas, Ioannis-Fivos, Schmelzle, Moritz, Schoening, Wenzel, Lurje, Georg, Biebl, Matthias, Pratschke, Johann, Fikatas, Panagiotis
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7958852/
https://www.ncbi.nlm.nih.gov/pubmed/33801470
http://dx.doi.org/10.3390/jcm10051011
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author Raakow, Jonas
Megas, Ioannis-Fivos
Schmelzle, Moritz
Schoening, Wenzel
Lurje, Georg
Biebl, Matthias
Pratschke, Johann
Fikatas, Panagiotis
author_facet Raakow, Jonas
Megas, Ioannis-Fivos
Schmelzle, Moritz
Schoening, Wenzel
Lurje, Georg
Biebl, Matthias
Pratschke, Johann
Fikatas, Panagiotis
author_sort Raakow, Jonas
collection PubMed
description Diaphragmatic hernia (DH) after a liver resection (LR) is an uncommon but potentially severe complication. In this retrospective study, we aim to share our experience with DH in our hepatic surgery center. We retrospectively analyzed 3107 patients who underwent a liver resection between January 2012 and September 2019. The diagnosis of DH was based on clinical examination and radiological imaging and confirmed by intraoperative findings during surgical repair. Five out of 3107 (0.16%) patients after LR developed DH. Especially, all five DH patients had a major right-sided LR before (n = 716, 0.7%). The mean time interval between initial LR and occurrence of DH was 30 months (range 15 to 44 months). DH exclusively occurred after a right or extended right hepatectomy. Two patients underwent emergency surgery, three were asymptomatic, and DH was diagnosed in follow-up imaging. Three of these five treated patients (60%) developed DH recurrence: two of three (67%) patients after suture repair alone and the only patient after suture repair in combination with an absorbable mesh. The patient who was treated with a composite mesh implant did not show any signs of DH recurrence after 52 months of follow-up. In patients who develop DH after liver surgery, a mesh augmentation with nonresorbable material is generally recommended. In order to diagnose these patients in an early state, we recommend that special attention be paid and a prompt and targeted diagnostic examination of patients with abdominal complaints after right-sided liver resections take place.
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spelling pubmed-79588522021-03-16 Incidence, Diagnosis and Repair of a Diaphragmatic Hernia Following Hepatic Surgery: A Single Center Analysis of 3107 Consecutive Liver Resections Raakow, Jonas Megas, Ioannis-Fivos Schmelzle, Moritz Schoening, Wenzel Lurje, Georg Biebl, Matthias Pratschke, Johann Fikatas, Panagiotis J Clin Med Article Diaphragmatic hernia (DH) after a liver resection (LR) is an uncommon but potentially severe complication. In this retrospective study, we aim to share our experience with DH in our hepatic surgery center. We retrospectively analyzed 3107 patients who underwent a liver resection between January 2012 and September 2019. The diagnosis of DH was based on clinical examination and radiological imaging and confirmed by intraoperative findings during surgical repair. Five out of 3107 (0.16%) patients after LR developed DH. Especially, all five DH patients had a major right-sided LR before (n = 716, 0.7%). The mean time interval between initial LR and occurrence of DH was 30 months (range 15 to 44 months). DH exclusively occurred after a right or extended right hepatectomy. Two patients underwent emergency surgery, three were asymptomatic, and DH was diagnosed in follow-up imaging. Three of these five treated patients (60%) developed DH recurrence: two of three (67%) patients after suture repair alone and the only patient after suture repair in combination with an absorbable mesh. The patient who was treated with a composite mesh implant did not show any signs of DH recurrence after 52 months of follow-up. In patients who develop DH after liver surgery, a mesh augmentation with nonresorbable material is generally recommended. In order to diagnose these patients in an early state, we recommend that special attention be paid and a prompt and targeted diagnostic examination of patients with abdominal complaints after right-sided liver resections take place. MDPI 2021-03-02 /pmc/articles/PMC7958852/ /pubmed/33801470 http://dx.doi.org/10.3390/jcm10051011 Text en © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Raakow, Jonas
Megas, Ioannis-Fivos
Schmelzle, Moritz
Schoening, Wenzel
Lurje, Georg
Biebl, Matthias
Pratschke, Johann
Fikatas, Panagiotis
Incidence, Diagnosis and Repair of a Diaphragmatic Hernia Following Hepatic Surgery: A Single Center Analysis of 3107 Consecutive Liver Resections
title Incidence, Diagnosis and Repair of a Diaphragmatic Hernia Following Hepatic Surgery: A Single Center Analysis of 3107 Consecutive Liver Resections
title_full Incidence, Diagnosis and Repair of a Diaphragmatic Hernia Following Hepatic Surgery: A Single Center Analysis of 3107 Consecutive Liver Resections
title_fullStr Incidence, Diagnosis and Repair of a Diaphragmatic Hernia Following Hepatic Surgery: A Single Center Analysis of 3107 Consecutive Liver Resections
title_full_unstemmed Incidence, Diagnosis and Repair of a Diaphragmatic Hernia Following Hepatic Surgery: A Single Center Analysis of 3107 Consecutive Liver Resections
title_short Incidence, Diagnosis and Repair of a Diaphragmatic Hernia Following Hepatic Surgery: A Single Center Analysis of 3107 Consecutive Liver Resections
title_sort incidence, diagnosis and repair of a diaphragmatic hernia following hepatic surgery: a single center analysis of 3107 consecutive liver resections
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7958852/
https://www.ncbi.nlm.nih.gov/pubmed/33801470
http://dx.doi.org/10.3390/jcm10051011
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