Division of Gastrointestinal and Minimally Invasive Surgery, Department of Surgery, Carolinas Medical Center, Charlotte, North Carolina, USA.
J Laparoendosc Adv Surg Tech A. 2021 Jul;31(7):814-819. doi: 10.1089/lap.2021.0038. Epub 2021 May 12.
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.
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。