Dutta Sanjeev, Albanese Craig T
Department of Surgery, Division of Pediatric Surgery, Lucile Packard Children's Hospital at Stanford University Medical Center, Standford, California 94305-5733, USA.
J Laparoendosc Adv Surg Tech A. 2007 Jun;17(3):391-4. doi: 10.1089/lap.2006.0113.
Morgagni hernias are well suited to laparoscopic repair. A primary suture closure may result in tension on the repair, thereby predisposing the patient to a recurrence. A prosthetic patch (PP) can be used to provide a tension-free repair. In this study, we reviewed our experience with the laparoscopic PP repair of Morgagni hernias in children.
A retrospective chart review of all patients undergoing a laparoscopic Morgagni hernia repair using a PP was undertaken between November 2002 and January 2006. Outcome measures included age, gender, defect size, use of mesh, and outcome. The time of follow-up was from 6 to 37 months.
Seven (7) patients (6 male, 1 female) underwent a laparoscopic repair of Morgagni hernia during this time period. Six (6) patients had a congenital hernia, and 1 patient was thought to have an iatrogenic hernia following a sternotomy for heart surgery. Defect size ranged from 4 to 7 cm in maximum dimension. All operations were completed laparoscopically, no patients presented with recurrence, and no PP complications were encountered.
The laparoscopic repair of Morgagni hernia using a PP can be performed with relative ease and with a positive outcome, and may prevent future recurrence by effecting a tension-free repair.
Morgagni疝非常适合腹腔镜修复。一期缝合关闭可能导致修复处张力增加，从而使患者易于复发。可使用人工补片（PP）进行无张力修复。在本研究中，我们回顾了我们在儿童Morgagni疝腹腔镜PP修复方面的经验。
对2002年11月至2006年1月间所有接受腹腔镜使用PP修复Morgagni疝的患者进行回顾性病历审查。观察指标包括年龄、性别、缺损大小、补片使用情况及结果。随访时间为6至37个月。
在此期间，7例（6例男性，1例女性）患者接受了Morgagni疝的腹腔镜修复。6例患者为先天性疝，1例患者被认为是心脏手术胸骨切开术后的医源性疝。最大缺损尺寸为4至7厘米。所有手术均通过腹腔镜完成，无患者出现复发，也未遇到PP相关并发症。
使用PP进行Morgagni疝的腹腔镜修复相对容易且效果良好，通过进行无张力修复可预防未来复发。
