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成人 Morgagni 疝腹腔镜修补术的手术技巧。我们该怎么做?

Surgical technique in the laparoscopic repair of Morgagni hernia in adults. How do we do it?

机构信息

Regional Institute of Gastroenterology and Hepatology "O. Fodor", Cluj-Napoca, Romania.

University of Medicine and Pharmacy "Iuliu Hațieganu", Cluj-Napoca, Romania.

出版信息

Hernia. 2022 Oct;26(5):1389-1394. doi: 10.1007/s10029-021-02559-6. Epub 2022 Jan 10.

Abstract

INTRODUCTION

Adult Morgagni hernias are rare congenital diaphragmatic hernias, which can present with an array of symptoms based on the size and the contents of it. This article focuses primarily on the laparoscopic repair with transfascial suturing.

METHODS

A number of five patients over the course of 10 years were admitted in our clinic, one of them being admitted with emergency symptoms. Four of the patients were treated laparoscopically, one of them requiring conversion to open approach.

RESULTS

The median age was 53 (range 44-71), 80% of the patients being females. Four of the patients received laparoscopic treatment with transfascial suturing, the fifth being converted, but respecting the same technique. The median surgery duration was 110 min, with a median blood loss of 30 ml. Removal of the sac was attempted in two cases. Median hospitalization stay was 3 days, with a median follow-up of 21 months, with no postoperative complications reported.

CONCLUSIONS

Laparoscopic repair with transfascial suturing provides an feasible and efficient repair, compared to the other laparoscopic techniques. Although no postoperative complications were reported, the removal of the sac still remains an controversial issue.

摘要

简介

成人 Morgagni 疝是罕见的先天性膈疝,可根据疝囊大小和内容物表现出多种症状。本文主要关注经腹筋膜缝合的腹腔镜修补。

方法

在过去 10 年中,我们的诊所收治了 5 名患者,其中 1 名患者出现紧急症状。其中 4 名患者接受了腹腔镜治疗,其中 1 名患者需要转为开放手术。

结果

中位年龄为 53 岁(范围 44-71 岁),80%的患者为女性。4 名患者接受了经腹筋膜缝合的腹腔镜治疗,第 5 名患者转为开放手术,但采用了相同的技术。中位手术时间为 110 分钟,中位出血量为 30 毫升。在 2 例中尝试切除疝囊。中位住院时间为 3 天,中位随访时间为 21 个月,无术后并发症报告。

结论

与其他腹腔镜技术相比,经腹筋膜缝合的腹腔镜修补提供了一种可行且有效的修复方法。尽管没有报告术后并发症,但切除疝囊仍然是一个有争议的问题。

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