title: Iatrogenic thoracic migration of the stomach complicating laparoscopic nissen fundoplication.
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.
authors.affiliation: Department of Upper Gastrointestinal and Minimally Invasive Surgery, Hull Royal Infirmary, Anlaby Road, Kingston Upon Hull, East Yorkshire, England HU3 2JZ.
authors.forename: C J
authors.initials: CJ
authors.lastname: O'Boyle
authors.forename: K
authors.initials: K
authors.lastname: Heer
authors.forename: A
authors.initials: A
authors.lastname: Smith
authors.forename: P C
authors.initials: PC
authors.lastname: Sedman
authors.forename: W A
authors.initials: WA
authors.lastname: Brough
authors.forename: C M
authors.initials: CM
authors.lastname: Royston
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D018662:Fundoplication / Q000009:adverse effects* / Q000379:methods; D005764:Gastroesophageal Reflux / Q000601:surgery; D006551:Hernia, Hiatal / Q000209:etiology* / Q000601:surgery; D006801:Humans; D007049:Iatrogenic Disease; D010535:Laparoscopy / Q000009:adverse effects*; D007813:Laparotomy; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome