Fukuzawa Hiroaki, Tamaki Akihiko, Takemoto Jyunkichi, Morita Keiichi, Endo Kosuke, Iwade Tamaki, Yuichi Okata, Bitoh Yuko, Yokoi Akiko, Maeda Kosaku
Department of Pediatric Surgery, Kobe Children's Hospital, Kobe, Japan.
Asian J Endosc Surg. 2015 May;8(2):219-22. doi: 10.1111/ases.12172.
A large congenital diaphragmatic hernia needing patch repair has a high risk of recurrence. Thus, managing these large congenital diaphragmatic hernias under thoracoscopy has become a problem. Here, a large congenital diaphragmatic hernia that was repaired using Gerota's fascia under thoracoscopy is reported. In the present case, it was impossible to close the hernia directly under thoracoscopy because the hernia was too large. Gerota's fascia was raised up by the left kidney and used for the repair. The left colon adhering to Gerota's fascia was mobilized, and a large space was made under thoracoscopy. Gerota's fascia was fixed to the diaphragmatic defect. The patient's postoperative course was good, and there was no recurrence. This technique could be one option for repairing a large hernia under thoracoscopy.
需要补片修补的大型先天性膈疝复发风险很高。因此,在胸腔镜下处理这些大型先天性膈疝已成为一个问题。在此,报告一例在胸腔镜下使用肾周筋膜修补大型先天性膈疝的病例。在本病例中,由于疝太大,无法在胸腔镜下直接闭合疝。肾周筋膜被左肾抬起并用于修补。游离附着于肾周筋膜的左结肠,在胸腔镜下制造一个大空间。将肾周筋膜固定于膈肌缺损处。患者术后恢复良好,无复发。该技术可能是胸腔镜下修补大型疝的一种选择。