Parshin V D, Khetagurov M A
Sechenov First Moscow State Medical University, Moscow, Russia.
Khirurgiia (Mosk). 2018(8):36-45. doi: 10.17116/hirurgia2018836.
To clarify the indications for reconstructive surgery in patients with diaphragmatic hernia.
Retrospective trial has included 36 patients with diaphragmatic hernia for the period 1963-2017. There were 23 (63.9%) women and 13 (36.1%) men. The majority of patients (83%) underwent surgery at able-bodied age (18-60 years). 27 (75%) patients had hernia of weak diaphragmatic zones, 9 (25%) - posttraumatic hernia. Diaphragm repair was performed with primary suture. In 2 cases of posttraumatic hernia mesh endoprosthesis was used.
All patients were discharged. Postoperative complications arose in 4 (11.1%) patients, including 2 cases of mesh endoprosthesis deployment. Long-term outcome was followed-up in 15 patients from 6 months to 17 years. Recurrent hernia was absent in all cases.
Primary suture is acceptable for diaphragmatic hernia repair. Alloplastic repair is indicated for large defect, when primary suture is impossible or risk of its failure is high.
明确膈肌疝患者重建手术的适应证。
回顾性研究纳入了1963年至2017年期间的36例膈肌疝患者。其中女性23例（63.9%），男性13例（36.1%）。大多数患者（83%）在壮年期（18 - 60岁）接受手术。27例（75%）患者为膈肌薄弱区疝，9例（25%）为创伤后疝。采用一期缝合进行膈肌修补。2例创伤后疝使用了网片内置假体。
所有患者均出院。4例（11.1%）患者出现术后并发症，其中包括2例网片内置假体移位。对15例患者进行了6个月至17年的长期随访。所有病例均未出现复发性疝。
一期缝合可用于膈肌疝修补。当一期缝合不可能或失败风险高时，对于大的缺损应采用异体材料修补。
