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成人 Morgagni 疝腹腔镜修补术的技术与结果。

Technique and Outcomes in Laparoscopic Repair of Morgagni Hernia in Adults.

机构信息

Division of Gastrointestinal and Minimally Invasive Surgery, Department of Surgery, Carolinas Medical Center, Charlotte, North Carolina, USA.

出版信息

J Laparoendosc Adv Surg Tech A. 2021 Jul;31(7):814-819. doi: 10.1089/lap.2021.0038. Epub 2021 May 12.

Abstract

Morgagni hernias (MHs) are rare anteromedial congenital diaphragmatic hernias. This study describes the effectiveness of a laparoscopic approach for these defects. A prospectively collected institutional database at a tertiary referral center was queried for patients (≥18 years) with MHs. Fifteen adults underwent laparoscopic MH repair. Abdominal pain was the most common presentation (71.5%), and 2 patients (13.3%) presented with acute obstruction. Laparoscopic bridged mesh repair was the most common approach (66.7%) and was achieved by suturing a bridged synthetic mesh to the diaphragmatic portion of the defect and fixing it with transfascial sutures and/or tacks to the anterior abdominal wall. Primary suture repair was utilized for smaller defects. No mortalities or recurrences occurred after 20.2 months median follow-up. Laparoscopic synthetic mesh repair of adult MHs offers an effective hernia repair with minimal complications and no detected recurrences in long-term follow-up of this patient sample.

摘要

Morgagni 疝(MHs)是罕见的前内侧先天性膈疝。本研究描述了腹腔镜方法治疗这些缺陷的效果。在一个三级转诊中心的前瞻性收集的机构数据库中,对患有 MHs 的患者(≥18 岁)进行了查询。15 名成年人接受了腹腔镜 MH 修复。腹痛是最常见的表现(71.5%),2 名患者(13.3%)表现为急性梗阻。腹腔镜桥接网片修复是最常见的方法(66.7%),通过将桥接合成网片缝合到缺陷的膈部分,并通过跨筋膜缝线和/或缝合钉将其固定到前腹壁来实现。对于较小的缺陷,采用了原发性缝合修复。中位随访 20.2 个月后,无死亡或复发。在对该患者样本的长期随访中,腹腔镜合成网片修复成人 MH 提供了有效的疝修补,并发症最小,无复发。

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