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Esophageal hiatal hernias, most of which are transhiatal migrations of the gastric cardia into the mediastinum, include a minor category called paraesophageal hernias. Herniation of organs other than the stomach belongs to this category. A 75-year-old man who developed esophageal hiatal hernia of an isolated transverse colon underwent elective laparoscopic surgery. Intraoperative findings revealed a preserved phrenoesophageal attachment on the patient's left dorsal side. Sac excision, sutured cruroplasty, and Toupet fundoplication were performed. The postoperative course was uneventful, and the patient's stooping-induced dyspnea was relieved after surgery. Our literature review indicated that hiatal hernia of the isolated colon has the unique characteristic of causing secondary gastroduodenal outlet obstruction and shares a mutual nature with Type II hiatal hernia. Although rare, this uncommon type of hiatal hernia may be recognized as a distinct subtype of paraesophageal hernia., (© 2024 Asia Endosurgery Task Force and Japan Society of Endoscopic Surgery and John Wiley & Sons Australia, Ltd.)

Background/aim: This study aimed to evaluate the long-term survival outcomes from our previous study: a phase II study of neoadjuvant chemotherapy with S-1 plus oxaliplatin for cT4 or N2-3 advanced gastric cancer., Patients and Methods: The patients with clinical T4 and/or N2 or more lymph nodes received two cycles (3 weeks per cycle) of neoadjuvant chemotherapy with S-1 plus oxaliplatin (oxaliplatin at 130 mg/m2 on day 1 and S-1 at 80-120 mg/day on days 1 to 14), followed by gastrectomy with D2 lymphadenectomy. The final preplanned analysis of long-term outcomes, including overall and relapse-free survival, was performed. This trial has been completed and registered with the University Hospital Medical Information Network Clinical Trials Registry under number UMIN 000024656., Results: Between May 2016 and March 2019, 30 patients were enrolled. All patients completed the protocol. After a median follow-up of 50 months for surviving patients, the 3-year overall and recurrence-free survival rates were 80.0% and 76.7%, respectively, at the last follow-up in March 2023, whereas the 5-year overall and recurrence-free survival rates were 72.7% and 73.0%, respectively., Conclusion: The administration of two cycles of neoadjuvant chemotherapy with S-1 plus oxaliplatin, followed by D2 gastrectomy, was associated with relatively good long-term oncologic outcomes for patients with high-risk gastric cancer., (Copyright © 2024 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)