OA05.6. Incidence of Paraconduit Hernia After Open and Robotic Abdominal Stage Esophagectomy

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ID: 325963
2026
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Ranked #72 of 453 articles by views in diseases of the esophagus : official journal of the international society for diseases of the esophagus

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Abstract
Abstract Topic Esophageal Cancer: Surgical Treatment of Esophageal Cancer – early outcomes and complications Background Paraconduit hernia is an uncommon but potentially serious complication following esophagectomy. The influence of abdominal operative approach, particularly robotic abdominal stage, on the incidence and timing of paraconduit hernia remains unclear. This study evaluated paraconduit hernia occurrence following open versus robotic abdominal stage esophagectomy. Methods All patients undergoing esophagectomy between October 2019 and May 2025 at a single high-volume centre were retrospectively analysed. Patients undergoing laparoscopic abdominal operations were excluded. Surgical approach was categorised by abdominal stage as open or robotic, with thoracic stage performed using open or minimally invasive techniques. Paraconduit hernia was defined as herniation adjacent to the gastric conduit diagnosed on computed tomography. Incidence and timing of paraconduit hernia were recorded. Rates were compared between groups using chi-square testing, with statistical significance defined as p<0.05. Results A total of 321 patients were analysed, including 179 undergoing open abdominal stage and 142 robotic abdominal stage. Median follow-up was 21 months. Paraconduit hernia occurred in 9 patients (2.8%). Incidence was significantly higher following robotic abdominal stage compared with open abdominal stage (5.6% vs 0.6%, p=0.006). One patient in the open group was diagnosed on postoperative day 6. In the robotic group, diagnoses occurred on postoperative days 3 and 4, day 35, at 5 months, 8 months, and in three cases more than one year postoperatively. All patients required surgical reoperation. Conclusion Paraconduit hernia is an infrequent but clinically significant complication following esophagectomy, occurring more commonly after robotic abdominal stage. Presentation may be early or delayed, and all cases required reoperation. Awareness of this risk is important during adoption of robotic techniques, and preventive strategies should be considered.
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Authors Natawadee Chantima, Isabel Miglior, Jakub Chmelo, Joshua Brown, Maziar Navidi, Alexander Phillips
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Journal diseases of the esophagus : official journal of the international society for diseases of the esophagus
Year 2026
DOI
10.1093/dote/doag077.040
URL
https://doi.org/10.1093/dote/doag077.040
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