title: [Diaphragmatic hernia complicated with diaphragmatic resection by automatic stapling device].
abstract: Nowadays, a diaphragmatic lesion is sometimes resected with use of an automatic stapling device, especially through video-assisted thoracoscopic procedure. We herein report 2 patients with a diaphragmatic hernia after diaphragmatic resection by automatic stapling devices. Etiology and cause of postoperative diaphragmatic hernia are discussed. Diaphragmatic resection by mechanical stapler was performed for thymic epithelial tumor recurring at the diaphragmatic pleura in both patients: 48-year-old man and 72-year-old woman. The former patient underwent a right diaphragmatic resection (3×4 cm in size) with a cartridge of mechanical stapler. Computed tomography (CT) and magnetic resonance imaging showed asymptomatic right diaphragmatic hernia 2 months after surgery. No symptom and progression occurred 8 years later. The latter patient underwent a right diaphragmatic resection (6×7 cm in size) with 2 cartridges of mechanical stapler. Diaphragmatic hernia advanced 7 months after surgery and required surgical intervention. Diaphragmatic repair was successful with the use of 8×6 cm expanded polytetrafluoroethylene patch. Surgical stump after diaphragmatic resection with automatic stapling device is easy to rupture during diaphragmatic movement synchronized with respiratory movement. Diaphragmatic resection with use of stapling device, which is a simple procedure, should be contraindicated.
authors.affiliation: Department of General Thoracic Surgery, Jichi Medical University, Shimotsuke, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Minegishi
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Nakano
authors.forename: Tomoki
authors.initials: T
authors.lastname: Shibano
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Maki
authors.forename: Sayaka
authors.initials: S
authors.lastname: Mitsuda
authors.forename: Shinichi
authors.initials: S
authors.lastname: Yamamoto
authors.forename: Kenji
authors.initials: K
authors.lastname: Tetsuka
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Tsubochi
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Hasegawa
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Endo
mesh_terms: D000368:Aged; D003964:Diaphragm / Q000601:surgery*; D005260:Female; D006548:Hernia, Diaphragmatic / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D017792:Surgical Stapling