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腹腔镜下修复 Morgagni 疝。

Laparoscopic repair of Morgagni hernia.

作者信息

Yavuz Nihat, Yiğitbasi Rafet, Sunamak Oguzhan, As Abdullah, Oral Ceyhun, Erguney Sabri

机构信息

Cerrahpasa Medical Faculty, General Surgery Department, Istanbul University, Istanbul, Turkey.

出版信息

Surg Laparosc Endosc Percutan Tech. 2006 Jun;16(3):173-6. doi: 10.1097/00129689-200606000-00013.

Abstract

BACKGROUND

Morgagni hernia is a rare type of diaphragmatic hernia which represents less than 5% of all congenital diaphragmatic hernias. Patients are generally asymptomatic and are diagnosed incidentally. When symptomatic, it generates symptoms due to the compression of thoracic organs or compression of herniated intraabdominal organs. Once diagnosed, the condition requires prompt surgical correction. The defect is repaired either by primary suture or by the use of a prosthetic mesh. In adults, prosthetic mesh repair is preferred. Recently, laparoscopic repair of Morgagni hernia has been introduced and gained wide acceptance.

MATERIALS AND METHODS

Between 2002 and 2004, 5 patients with Morgagni hernia were treated laparoscopically at our department. Female/male ratio was 3/2. Mean age was 56 years (range 41 to 69 y). Diagnosis were made by chest x-ray and CT scan. Herniation was on the left in 2 patients, and on the right in 3. The content of hernial sac was transverse colon and stomach. There were 2 separate defects in a patient with left-sided hernia. All cases were laparoscopically treated using prosthetic material.

RESULTS

All operations were completed laparoscopically. The postoperative hospital stay was 3 to 5 days with a mean of 4 days. None of the patients developed any complication in the early postoperative period. The mean follow-up period is 7 months (range 3 to 24 mo). All patients are actually in good health and without recurrence.

CONCLUSION

Laparoscopic repair of Morgagni hernia is a safe, simple, and reliable procedure which presents all the advantages of the minimally invasive surgery.

摘要

背景

莫尔加尼疝是一种罕见的膈疝类型,占所有先天性膈疝的比例不到5%。患者通常无症状,多为偶然诊断。出现症状时,是由于胸腔器官受压或疝入的腹腔内器官受压所致。一旦确诊,该病需要及时进行手术矫正。缺损可通过一期缝合或使用人工补片修复。在成人中,人工补片修复更受青睐。最近,莫尔加尼疝的腹腔镜修复术已被引入并广泛接受。

材料与方法

2002年至2004年期间,我科对5例莫尔加尼疝患者进行了腹腔镜治疗。男女比例为3/2。平均年龄为56岁(范围41至69岁)。通过胸部X线和CT扫描进行诊断。2例患者疝位于左侧,3例位于右侧。疝囊内容物为横结肠和胃。1例左侧疝患者有2个独立的缺损。所有病例均采用人工材料进行腹腔镜治疗。

结果

所有手术均在腹腔镜下完成。术后住院时间为3至5天,平均4天。所有患者术后早期均未出现任何并发症。平均随访期为7个月(范围3至24个月)。所有患者目前健康状况良好,无复发。

结论

莫尔加尼疝的腹腔镜修复术是一种安全、简单且可靠的手术方法,具有微创手术的所有优点。

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