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莫尔加尼疝:腹腔镜治疗的技术变异

Morgagni hernia: technical variation in the laparoscopic treatment.

作者信息

Terrosu Giovanni, Brizzolari Marco, Intini Sergio, Cattin Federico, Bresadola Vittorio, De Anna Dino

机构信息

Udine School of Medicine, Italy.

出版信息

Ann Ital Chir. 2012 Sep-Oct;83(5):415-20.

Abstract

INTRODUCTION

Morgagni hernia is a rare entity that accounts for 3-5% of diaphragmatic hernias. They are mostly asymptomatic and discovered incidentally. Surgical treatment is indicated once diagnosis is made. Abdominal or thoracic accesses are possible using open or minimally invasive technique.

METHODS

We report two cases of laparoscopic assisted repair of Morgagni hernia conducted by primary closure of the diaphragmatic defect with extracorporeal nonabsorbable sutures anchoring the diaphragmatic edge at the muscular fascia of the abdominal wall.

RESULTS

Both patients had an uneventful postoperative recovery. The operative time was 90 and 60 minutes and the postoperative hospitalization was 4 and 2 days respectively.

CONCLUSIONS

Laparoscopic intervention for Morgagni hernia repair is easy, safe and less invasive compared to the open one, with reduced hospitalization time. Primary closure of the diaphragmatic defect with extracorporeal nonabsorbable sutures is an effective technique for Morgagni hernia; defects larger than 20-30 cm2 should be repaired using a prosthetic patch.

摘要

引言

莫尔加尼疝是一种罕见的疾病,占膈疝的3%-5%。它们大多无症状,多为偶然发现。一旦确诊即需进行手术治疗。可采用开放或微创技术经腹或经胸入路。

方法

我们报告两例腹腔镜辅助修复莫尔加尼疝的病例,通过体外不可吸收缝线将膈肌边缘固定于腹壁肌筋膜,对膈肌缺损进行一期缝合。

结果

两名患者术后恢复均顺利。手术时间分别为90分钟和60分钟,术后住院时间分别为4天和2天。

结论

与开放手术相比,腹腔镜干预修复莫尔加尼疝操作简便、安全且侵入性小,住院时间缩短。用体外不可吸收缝线对膈肌缺损进行一期缝合是治疗莫尔加尼疝的有效技术;大于20-30平方厘米的缺损应使用人工补片修复。

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