Technical Options and Approaches to Lengthen the Shortened Esophagus

Matthew G Hartwig; Sara Najmeh

doi:10.1016/j.thorsurg.2019.07.004

Technical Options and Approaches to Lengthen the Shortened Esophagus

Thorac Surg Clin. 2019 Nov;29(4):387-394. doi: 10.1016/j.thorsurg.2019.07.004.

Authors

Matthew G Hartwig¹, Sara Najmeh²

Affiliations

¹ Division of Thoracic Surgery, Duke University Health System, DUMC 3863, Durham, NC 27710, USA. Electronic address: Matthew.hartwig@duke.edu.
² Division of Thoracic Surgery, Duke University Health System, DUMC 3863, Durham, NC 27710, USA.

PMID: 31564395
DOI: 10.1016/j.thorsurg.2019.07.004

Abstract

Failure to recognize a short esophagus during paraesophageal hernia repair can lead to poor functional outcomes and increased recurrence rates. Diagnosis is usually done intraoperatively when less than 2 to 3 cm of esophagus lie in the intraabdominal position. If aggressive esophageal mediastinal mobilization is unable to lengthen the esophagus, the surgeon should perform an esophageal lengthening procedure. A modified Collis gastroplasty is most commonly used and can be performed through a variety of transabdominal or transthoracic approaches. These procedures are safe, durable, and associated with good long-term outcomes. Patient selection and safe surgical technique are key in avoiding complications.

Keywords: Collis; Gastroplasty; Paraesophageal; Reflux; Short esophagus.

Publication types

Review

MeSH terms

Esophagus / pathology*
Fundoplication / methods*
Gastroplasty / methods*
Hernia, Hiatal / surgery*
Herniorrhaphy / methods*
Humans
Laparoscopy
Mediastinum
Organ Size
Patient Selection