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成年患者膈肌疝修补术:一项回顾性机构经验

Diaphragmatic Hernia Repair in Adult Patients: A Retrospective Institutional Experience.

作者信息

Gomes-da Silva de Rosenzweig Pablo, Vázquez-Minero Juan C, Delgado-Casillas Oscar M, Palomares-Capetillo Paola, Ramírez Vidales Jorge Alejandro, Cruz Marco, Vazquez-Loredo Victor H

机构信息

Thoracic Surgery Department, Instituto Nacional de Enfermedades Respiratorias, Mexico City, MEX.

出版信息

Cureus. 2024 Nov 27;16(11):e74601. doi: 10.7759/cureus.74601. eCollection 2024 Nov.

Abstract

Objectives Diaphragmatic hernias (DHs) in adults are an uncommon condition in which general characteristics and treatment strategies are poorly described. The objective of this study was to describe our institutional experience in the surgical repair of DH in adult patients. Methods A cross-sectional review was conducted on adult patients with DH who were diagnosed and surgically treated between 2012 and 2023 at the Instituto Nacional de Enfermedades Respiratorias in Mexico City. Results A total of 24 patients were included in this study, with a predominance of females (65.2%). The mean age for our study was 50 years (±4). Bochdalek hernias were the most commonly encountered (50%), followed by Morgagni hernias (25%), traumatic hernias (17%), and type IV hiatal hernias (8%). Admission (programmed vs. emergency) between surgical techniques was statistically different (p= 0.032), in addition to the development of complications between surgical techniques (p= 0.037). The mean time patients were hospitalized was 20 days (±2), with no mortality nor readmission after discharge. Conclusion Considering the outcomes of our study, both open thoracic and abdominal approaches seem feasible for treating DH in adults.

摘要

目的 成人膈疝(DHs)是一种罕见疾病,其一般特征和治疗策略的描述较少。本研究的目的是描述我们机构在成年患者膈疝手术修复方面的经验。方法 对2012年至2023年期间在墨西哥城国家呼吸疾病研究所被诊断并接受手术治疗的成年膈疝患者进行横断面回顾。结果 本研究共纳入24例患者,女性占多数(65.2%)。我们研究的平均年龄为50岁(±4岁)。Bochdalek疝最为常见(50%),其次是Morgagni疝(25%)、创伤性疝(17%)和IV型食管裂孔疝(8%)。手术技术之间的入院情况(计划性与急诊)在统计学上存在差异(p = 0.032),手术技术之间并发症的发生情况也存在差异(p = 0.037)。患者的平均住院时间为20天(±2天),出院后无死亡或再入院情况。结论 考虑到我们的研究结果,开放胸段和腹段入路在治疗成人膈疝方面似乎都是可行的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/48f8/11680463/9ea1d086e960/cureus-0016-00000074601-i01.jpg

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