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Iatrogenic thoracic migration of the stomach complicating laparoscopic Nissen fundoplication |
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| Authors: | C J O'Boyle K Heer A Smith P C Sedman W A Brough C M S Royston |
| Institution: | (1) Department of Upper Gastrointestinal and Minimally Invasive Surgery, Hull Royal Infirmary, Anlaby Road, Kingston Upon Hull, East Yorkshire, England HU3 2JZ, GB;(2) Department of Upper Gastrointestinal and Minimally Invasive Surgery, Stepping Hill Hospital, Poplar Grove, Stockport, Cheshire, England SK2 7JE, GB |
| Abstract: | Background: Intrathoracic gastric herniation after laparoscopic Nissen fundoplication is an uncommon but potentially life-threatening complication that may present in the early or late postoperative period. Methods: A retrospective analysis was performed on all patients undergoing antireflux surgery from December 1991 to June 1999. Results: Nine cases of gastric herniation occurred after 511 operations (0.17%). Patients presented with the condition 4 days to 29 months after surgery. Eight of these nine patients (89%) had reported vomiting in the immediate postoperative period. Seven patients (78%) reported persistent odynophagia. A factor common to all patients was that posterior crural repair had not been performed. Conclusions: Measures should be undertaken to prevent postoperative vomiting after laparoscopic Nissen fundoplication. Posterior crural repair is essential after surgery in all cases. Received: 12 July 1999/Accepted: 22 November 1999/Online publication: 8 May 2000 |
| Keywords: | : Complication — Fundoplication — Gastric herniation — Laparoscopy |
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