459. DIAPHRAGMATIC RELAXING INCISION IN THE REPAIR OF DIAPHRAGMATIC HERNIA FOLLOWING OESOPHAGECTOMY: A RETROSPECTIVE STUDY

Abstract Background After oesophagectomy diaphragmatic hernia (DH) is a well-known long-term complication. Approximating the crura around the tubular stomach is often challenging, especially in cases with a wide hiatus. This study evaluates a surgical technique involving a relaxing incision. Methods This retrospective study included all post-oesophagectomy patients from 2016 to 2023 who underwent repair for diaphragmatic hernia. Primary outcome measures included incidence over time, postoperative complications, recurrence of DH, surgical technique, and length of hospital stay. Results 13 patients were included, the relaxing incision was 12 times located on the left side and once on the right. All patients experienced symptoms and 81.3% of the patients were males. The median diameter of the hernia was 70 mm (range 65-100 mm), and the median of the surgical duration was 155 minutes. Complications occurred in 2 patients (2 times transient dysphagia). One recurrence was observed 13 months postoperatively, requiring reintervention. The median hospitalization length was 6 days, with 30.8% needing readmission. In Table 1 additional outcomes and characteristics are presented. Conclusion As far as known, this is the largest series of patients post-oesophagectomy in whom DH was repaired using a diaphragmatic relaxation incision. The relaxation incision proves to be a safe method for achieving an effective cruraplasty. It is essential for experienced laparoscopic surgeons to be aware of this technique when managing post-oesophagectomy patients.