AB049. SOH26AB_0038. Impact of surgical approach on paraconduit herniation rate after oesophagectomy: an unmatched cohort study
Upper GI Session

AB049. SOH26AB_0038. Impact of surgical approach on paraconduit herniation rate after oesophagectomy: an unmatched cohort study

Uzair Asad, Domhnall O’Connor, Mohammed Albagir, Mohammed Alazzawi, Mayilone Arumugasamy, William Robb, Jarlath Bolger

Department of Surgery, Beaumont Hospital, Dublin, Ireland

Background: Paraconduit hernia is an uncommon complication after oesophagectomy. It is thought to be related to the widening of the oesophageal hiatus in pursuit of a clear circumferential resection margin. The clinical presentation can vary from incidental findings during surveillance to catastrophic visceral ischaemia. A considerable risk factor is a minimally invasive approach. The aim of this study was to determine the impact of surgical approach on paraconduit herniation.

Methods: All oesophagectomies from 2019 to 2023 performed at Beaumont Hospital were included. Demographics, operative approach, and clinico-pathological data were extracted. Statistical analyses were conducted using MinitabTM v18.

Results: A total of 190 oesophagectomies were performed during the study period. The mean age was 66±9.8 years. Male patients represented 78% (n=148) of cases. Surgical approaches observed were: minimally invasive oesophagectomy (MIO) 34%, robotically-assisted MIO (RAMIO) 33%, hybrid 32%, and open in 1% of cases. The overall rate of paraconduit hernia was 11.6% (22/190). Five/22 occurred within 3 months of oesophagectomy, and 10/22 presented symptomatically. The rate of herniation among the different approaches was: hybrid 4/60, RAMIO 12/63, and MIO 6/65 (P=0.08).

Conclusions: This observational study has demonstrated a trend towards higher paraconduit hernia rates in robotically assisted oesophagectomies, but without statistical significance, and at comparable rates to international cohorts.

Keywords: Paraconduit hernia; oesophagectomy; minimally invasive surgery; robotic-assisted oesophagectomy; postoperative complications

Acknowledgments

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Footnote

Funding: None.

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-26-ab049
Cite this abstract as: Asad U, O’Connor D, Albagir M, Alazzawi M, Arumugasamy M, Robb W, Bolger J. AB049. SOH26AB_0038. Impact of surgical approach on paraconduit herniation rate after oesophagectomy: an unmatched cohort study. Mesentery Peritoneum 2026;10:AB049.

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