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Collis Nissen procedure after lung transplantation and laparoscopic management of mediastinal hematoma

B Dallemagne, MD S Perretta, MD, PhD HA Mercoli, MD L Marx, MD J Marescaux, MD, FACS, Hon FRCS, Hon FJSES, Hon FASA, Hon APSA
Epublication WebSurg.com, Nov 2014;14(11). URL: http://websurg.com/doi/vd01en4327

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  • 2014-11-14
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After lung transplantation, GERD causes inflammatory reactions, increasing risks for obliterating bronchiolitis and dysfunctioning graft. Authors first present a laparoscopic Collis Nissen procedure for hiatal hernia and severe esophagitis in a grafted patient. Because of a short esophagus despite extended dissection, a Collis gastroplasty is required. After stapling, cruroplasty is performed, finally followed by a Nissen fundoplication. In case of severe esophagitis, a difficult dissection and inflammatory tissues can lead to more complications such as leak, hemorrhage, slippage, and abscess. Mediastinal hematoma is diagnosed on postoperative day 9, mandating a redo emergency intervention. This rare complication will be managed laparoscopically.