Oh Siwon, Lim Suk Kyung, Cho Jong Ho, Kim Hong Kwan, Choi Yong Soo, Kim Jhingook, Shim Young Mog, Lee Junghee
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
J Chest Surg. 2023 May 5;56(3):171-176. doi: 10.5090/jcs.22.129. Epub 2023 Jan 30.
This study analyzed and described the clinical characteristics and surgical outcomes of diaphragmatic hernia (DH) repair according to the operative approach.
After excluding cases with a combined approach and hiatal hernias, we analyzed 26 patients who underwent DH repair between 1994 and 2018. The baseline and perioperative characteristics of the thoracic approach group and the abdominal approach group were described and analyzed.
Fifteen of the 26 patients were treated through the thoracic approach, including 5 patients who underwent video-assisted thoracic surgery (VATS). Eleven patients underwent the abdominal approach. The thoracic approach was associated with a longer duration of DH than the abdominal approach (2 vs. 0.1 months), herniation of the right-sided abdominal organs, and herniation of the retroperitoneal organs. During the median follow-up of 23 months, there was no recurrence of DH.
The surgical approach should be chosen considering the duration of DH and the location of herniated organs. VATS might be a safe and feasible option for repairing DH.
本研究根据手术入路分析并描述了膈肌疝(DH)修补术的临床特征和手术结果。
在排除联合入路和食管裂孔疝病例后,我们分析了1994年至2018年间接受DH修补术的26例患者。描述并分析了胸腔入路组和腹腔入路组的基线和围手术期特征。
26例患者中有15例通过胸腔入路治疗,其中5例接受了电视辅助胸腔镜手术(VATS)。11例患者接受了腹腔入路。胸腔入路与DH持续时间长于腹腔入路(2个月对0.1个月)、右侧腹部器官疝出和腹膜后器官疝出有关。在中位随访23个月期间,未出现DH复发。
应根据DH持续时间和疝出器官的位置选择手术入路。VATS可能是修复DH的一种安全可行的选择。