Horstmann O, Neufang T, Post S, Stephan H, Becker H
Klinik für Allgemeinchirurgie, Georg August Universität Göttingen.
Chirurg. 1996 Jul;67(7):744-7.
Diagnosis of blunt diaphragmatic rupture is still a challenging problem. This injury is generally treated by direct closure of the defect via a laparotomy or a thoracotomy. As it occurs frequently in severely traumatized patients, we wondered whether those patients could benefit from the well-known advantages of minimally invasive surgery. We report the records of two patients who underwent laparoscopy for blunt diaphragmatic hernia. In both patients, the hernia was laparoscopically closed without opening the abdomen. We did not see any intra- or postoperative complications related to minimally invasive surgery; the postoperative recovery was impressively short. Taking into account the fact that diaphragmatic ruptures are frequently misdiagnosed, we recommend laparoscopy as a useful tool in cases where these injuries may be suspected. In selected patients, primary closure of the defect may be achieved within the same laparoscopy so that laparotomy can be avoided.
钝性膈肌破裂的诊断仍然是一个具有挑战性的问题。这种损伤通常通过开腹手术或开胸手术直接闭合缺损来治疗。由于它经常发生在严重创伤的患者中，我们想知道这些患者是否能从微创手术的众所周知的优势中获益。我们报告了两名因钝性膈肌疝接受腹腔镜手术的患者的记录。在这两名患者中，疝均通过腹腔镜闭合，未打开腹腔。我们未发现任何与微创手术相关的术中或术后并发症；术后恢复时间短得惊人。考虑到膈肌破裂经常被误诊这一事实，我们建议在怀疑有这些损伤的情况下，腹腔镜是一种有用的工具。在选定的患者中，可在同一腹腔镜手术中实现缺损的一期闭合，从而避免开腹手术。
