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儿童 Morgagni 疝的腹腔镜修补术。

Laparoscopic Repair of Morgagni Hernia in Children.

机构信息

Sisli Hamidiye Etfal Training and Research Hospital, Department of Pediatric Surgery, Istanbul, Turkey.

Istanbul University, Istanbul Medical Faculty, Department of Pediatric Surgery, Istanbul, Turkey.

出版信息

J Pediatr Surg. 2023 Sep;58(9):1670-1673. doi: 10.1016/j.jpedsurg.2023.01.045. Epub 2023 Jan 26.

Abstract

PURPOSE

This study aimed to evaluate our patients who underwent laparoscopic-assisted transabdominal repair for Morgagni hernia (MH).

METHODS

We retrospectively reviewed patients who underwent laparoscopy-assisted transabdominal repair using loop sutures for MH between March 2010 and April 2021. Demographic data, symptoms, operative findings, operation methods, and postoperative complications of the patients were reviewed.

RESULTS

A total of 22 patients with MH were treated with laparoscopy-assisted transabdominal repair using loop suture. There were 6 girls (27.2%) and 16 boys (72.7%). Two patients had Down syndrome, and two patients had cardiac defects (secundum atrial septal defect, patent foramen ovale). One patient had a V-P shunt due to hydrocephalus. One patient had cerebral palsy. The mean operation time was 45 min (30-86 min). The hernia sac was not removed, and a patch was not used in any of the patients. The mean hospitalization time was 1.7 days (1-5 days). One patient's defect was very large, and another patient's liver was densely attached to the liver sac, causing bleeding during dissection. In total, two patients were converted to open surgery. There was no recurrence during the follow-up.

CONCLUSION

Laparoscopy-assisted transabdominal repair is an efficient and safe choice for the repair of MH. Leaving the hernia sac does not increase the recurrence, so there is no need to dissect the sac.

摘要

目的

本研究旨在评估接受腹腔镜辅助经腹修补术治疗 Morgagni 疝(MH)的患者。

方法

我们回顾性分析了 2010 年 3 月至 2021 年 4 月期间接受腹腔镜辅助经腹修补术采用 Loop 缝线治疗 MH 的患者。回顾患者的人口统计学数据、症状、手术发现、手术方法和术后并发症。

结果

共 22 例 MH 患者接受腹腔镜辅助经腹修补术采用 Loop 缝线治疗。其中 6 例为女孩(27.2%),16 例为男孩(72.7%)。2 例患者患有唐氏综合征,2 例患者患有心脏缺损(房间隔缺损,卵圆孔未闭)。1 例患者因脑积水行 V-P 分流术。1 例患者患有脑瘫。手术时间平均为 45 分钟(30-86 分钟)。所有患者均未切除疝囊,也未使用补片。平均住院时间为 1.7 天(1-5 天)。1 例患者的缺损非常大,另 1 例患者的肝脏与疝囊紧密粘连,导致在解剖过程中出血。总共 2 例患者转为开放手术。随访期间无复发。

结论

腹腔镜辅助经腹修补术是 MH 修补的有效且安全的选择。保留疝囊不会增加复发的风险,因此无需解剖疝囊。

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