Laituri Carrie A, Garey Carissa L, Ostlie Daniel J, Holcomb George W, St Peter Shawn D
Department of Surgery, Children's Mercy Hospital, Kansas City, Missouri 64108, USA.
J Laparoendosc Adv Surg Tech A. 2011 Jan-Feb;21(1):89-91. doi: 10.1089/lap.2010.0174. Epub 2011 Jan 8.
Morgagni hernias are anteromedial diaphragmatic defects that are typically simple to repair. As opposed to posterolateral defects, which are very difficult to expose laparoscopically, the anterior defects can be easily seen with this approach. We reviewed our experience with laparoscopic and open repair of Morgagni hernias in children and their associated outcomes.
A retrospective review was conducted on all patients who underwent repair of Morgagni hernia from January 1994 to May 2009.
Seventeen patients were identified, of whom 9 underwent laparoscopic repair and 8 underwent an open repair. The mean age at operation was 3 years (newborn to 14 years) with a mean weight of 20.7 kg (3.6-87.6 kg). Intraoperatively, the diaphragmatic defect size in maximal dimension ranged from 3 to 11 cm. There was no difference in the average age, weight, and defect size among both groups. Of those who underwent laparoscopic hernia repair, 5 patients were closed with a Surgisis-Gold (SIS) patch, 1 was closed primarily with interrupted sutures, and 3 were closed with transabdominal sutures. In the open group, 7 were closed primarily and 1 required SIS patch for closure. Mean length of stay was 3.0 ± 1.5 days in the open group compared with 1.1 ± 0.4 days in the laparoscopic group (P < 0.01). There were no intraoperative complications and no recurrences.
Laparoscopic repair of Morgagni hernias is a relatively simple and effective method of repair in children with accentuated advantages of minimally invasive surgery.
莫尔加尼疝是膈肌前内侧缺损，通常修复起来较为简单。与后外侧缺损不同，后外侧缺损很难通过腹腔镜暴露，而前侧缺损采用这种方法很容易看到。我们回顾了我们在儿童莫尔加尼疝腹腔镜和开放修复方面的经验及其相关结果。
对1994年1月至2009年5月期间所有接受莫尔加尼疝修复的患者进行回顾性研究。
共确定17例患者，其中9例行腹腔镜修复，8例行开放修复。手术平均年龄为3岁（新生儿至14岁），平均体重为20.7 kg（3.6 - 87.6 kg）。术中，膈肌缺损最大尺寸范围为3至11 cm。两组患者的平均年龄、体重和缺损大小无差异。在接受腹腔镜疝修补术的患者中，5例用Surgisis - Gold（SIS）补片关闭，1例主要用间断缝合关闭，3例用经腹缝合关闭。在开放组中，7例主要缝合关闭，1例需要SIS补片关闭。开放组平均住院时间为3.0±1.5天，而腹腔镜组为1.1±0.4天（P < 0.01）。术中无并发症，无复发。
腹腔镜修复莫尔加尼疝是儿童相对简单有效的修复方法，具有微创手术的突出优势。
