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Firstly safety to treatment of morgagni hernia: Transthoracic apporach

Year 2015, , 65 - 70, 07.09.2015
https://doi.org/10.5505/sakaryamj.2015.87088

Abstract

Introduction: Morgagni hernia represents a rare type of diaphragmatic hernia. It occurs due to herniation of intraabdominal organs via foramen of Larey which is located both side of sternum. Treatment is primarily surgical and transthoracic, transabdominal approachs or endoscopically methods are amenable. Material-Method: We retrospectively analyzed the records of 13 patients were operated via thorachotomy. Age, sex, presenting symptoms, lesion location, applied surgical method, duration of the hospital stay, morbidity and mortality rates were reviewed. Results: 10 (76.9%) were female and 3 (23 %) were male. Mean age was 63 years (14-87 years). Hernias were located on the right side in 10 cases, the left side in 3. Herniated organs were: omentum and colon in 7 (53.8%), only omentum in 4 (30.7%), omentum and stomach in 2 (15.3 %) Mean hospital stay was 6.7 days. There were no mortalities observed. There was no recurrence during the follow-up of 16.3 months (6-36 months).Conclusion: In treatment of morgagni hernia, transthoraccic apporachs should be prefered inspite of transabdominal and endoscopically methods because it is safety, effective and has low reccurrens ratio.

References

  • Kiliç D, Nadir A, Döner E, Kavukçu S, Akal M, Ozdemir N,et al. (2001) Transthoracic approach in surgical management of Morgagni hernia. Eur J Cardiothorac Surg 20:1016–1019
  • McBride CA, Beasley S. Re: Laparoscopic repair of diaphragmatic Morgagni hernia in children: review of 3 cases. J Pediatr Surg. 2011; 46: 1470.
  • Dilber E, Göçmen A, Kiper N, Özçelik U, Doğru D ,Büyükpamukçu N, F. Tanye, FC Konjenital diyafram hernili hastalarda ilk bulgular ve uzun süreli solunum fonksiyonları. Çocuk Sağlığı ve Hastalıkları Dergisi 2002; 46: 177-181
  • Kurkcuoglu IC, Eroglu A, Karaoglanoglu N, Polat P , Balik AA, Tekinbaş C . Diagnosis and Surgical Treatment of Morgagni Hernia: Report of Three Cases Surg Today (2003) 33:525–528
  • Eren S, Ciris F (2005) Diaphragmatic hernia: diagnostic approacheswith review of the literature. Eur J Radiol 54:448–459
  • Pousios D, Panagiotopoulos N, Piyis A, Gourgiotis S Transthoracic Repair of Asymptomatic Morgagni Hernia in an Adult Indian J Surg (September–October 2012) 74(5):431–433 DOI 10.1007/s12262-011-0304-8
  • Federico JA, Ponn RB. Foramen of Morgagni hernia. In: Shields TW, LoCicero III J, Ponn RB, editors. General thoracic surgery.5th ed. Philadelphia: Lippincott Williams and Wilkins; 2000. p. 647–60.
  • Gander JW, Fisher JC, Gross ER, Reichstein AR, Cowles RA, Aspelund G, et al. Early recurrence of congenital diaphragmatic hernia is higher after thoracoscopic than open repair: a single institutional study.J Pediatr Surg. 2011 Jul;46(7):1303-8. doi: 10.1016/j.jpedsurg.2010.11.048.
  • Loong TP, Kocher HM (2005) Clinical presentation and operative repair of hernia of Morgagni. Postgrad Med J 81:41–44
  • Paris F, Tarazona V, Casillas M, Blasco E, Canto A, Pastor J, et al. Hernia of Morgagni. Thorax 1973;28:631–636.
  • Lansdale N, Alam S, Losty PD. Neonatal endosurgical congenital diaphragmatic hernia repair: a systematic review and meta-analysis. Ann Surg 2010;252:20-6.
  • McHoney M, Giacomello L, Nah SA. Thoracoscopic repair of congenital diaphragmatic hernia: intraoperative ventilation and recurrence. J Pediatr Surg 2010;45:355-9.
  • Lao OB, Crouthamel MR, Goldin AB. Thoracoscopic repair of congenital diaphragmatic hernia in infancy. J Laparoendosc Adv Surg Tech 2010;20:271-6.
  • Shah S, Wishnew J, Barsness K. Minimally invasive congenital diaphragmatic hernia repair: a 7-year review of one institution's experience. Surg Endosc 2009;23:1265- 71.
  • Guner YS, Chokshi N, Aranda A, et al. Thoracoscopic repair of neonatal diaphragmatic hernia. J Laparoendosc Adv Surg Tech 2008;18:875-80.

Morgagani hernilerinin tedavisinde önce güvenlik: Transtorasik yaklaşım

Year 2015, , 65 - 70, 07.09.2015
https://doi.org/10.5505/sakaryamj.2015.87088

Abstract

Giriş: Morgagni hernisi tüm difragma hernileri içinde nadiren görülür. Sternumun her iki tarafında bulunan Larrey boşluğundan batın içi organların fıtıklaşması sonucu meydana gelir. Tedavisi cerrahidir ve bu amaçla transtorasik, transabdominal yaklaşımlar ve endoskopik yöntemler kullanılabilir.Materyal-Metod: Bu çalışmada, morgagni hernisi nedeniyle transtorasik yaklaşımla tedavi edilen 13 hasta yaş, cinsiyet, semptom, tanı yöntemleri, lezyonun lokalizasyonu,cerrahi yöntem, hastanede kalış süresi, morbidite ve mortalite açısından retrospektif olarak incelendi. Sonuçlar: Hastaların 10'u (% 76,9) kadın, 3'ü (%23,09) erkekti. Yaş ortalaması 63 (14-87) olarak tespit edildi. Herni 10 olguda sağ, 3 olguda soldaydı. Herni kesesi içinde 7 hastada omentum ve kolon, 4 hastada yalnızca omentumun, 2 hastada mide ve omentumun olduğu tespit edildi.Bütün hastalara transtorasik yaklaşım ile müdahale edildi. Ortalama hastanede kalış süresi 6,7 gündü. (5-10 gün). Moratlite görülmedi. Ortalama 16,3 aylık takip süresi içinde nüks tespit edilmedi.Tartışma: Transtorasik yaklaşımlar, efektif ve güvenli olması ve düşük nüks oranları nedeniyle transabdominal ve endoskopik yöntemlere tercih edilmelidir.

References

  • Kiliç D, Nadir A, Döner E, Kavukçu S, Akal M, Ozdemir N,et al. (2001) Transthoracic approach in surgical management of Morgagni hernia. Eur J Cardiothorac Surg 20:1016–1019
  • McBride CA, Beasley S. Re: Laparoscopic repair of diaphragmatic Morgagni hernia in children: review of 3 cases. J Pediatr Surg. 2011; 46: 1470.
  • Dilber E, Göçmen A, Kiper N, Özçelik U, Doğru D ,Büyükpamukçu N, F. Tanye, FC Konjenital diyafram hernili hastalarda ilk bulgular ve uzun süreli solunum fonksiyonları. Çocuk Sağlığı ve Hastalıkları Dergisi 2002; 46: 177-181
  • Kurkcuoglu IC, Eroglu A, Karaoglanoglu N, Polat P , Balik AA, Tekinbaş C . Diagnosis and Surgical Treatment of Morgagni Hernia: Report of Three Cases Surg Today (2003) 33:525–528
  • Eren S, Ciris F (2005) Diaphragmatic hernia: diagnostic approacheswith review of the literature. Eur J Radiol 54:448–459
  • Pousios D, Panagiotopoulos N, Piyis A, Gourgiotis S Transthoracic Repair of Asymptomatic Morgagni Hernia in an Adult Indian J Surg (September–October 2012) 74(5):431–433 DOI 10.1007/s12262-011-0304-8
  • Federico JA, Ponn RB. Foramen of Morgagni hernia. In: Shields TW, LoCicero III J, Ponn RB, editors. General thoracic surgery.5th ed. Philadelphia: Lippincott Williams and Wilkins; 2000. p. 647–60.
  • Gander JW, Fisher JC, Gross ER, Reichstein AR, Cowles RA, Aspelund G, et al. Early recurrence of congenital diaphragmatic hernia is higher after thoracoscopic than open repair: a single institutional study.J Pediatr Surg. 2011 Jul;46(7):1303-8. doi: 10.1016/j.jpedsurg.2010.11.048.
  • Loong TP, Kocher HM (2005) Clinical presentation and operative repair of hernia of Morgagni. Postgrad Med J 81:41–44
  • Paris F, Tarazona V, Casillas M, Blasco E, Canto A, Pastor J, et al. Hernia of Morgagni. Thorax 1973;28:631–636.
  • Lansdale N, Alam S, Losty PD. Neonatal endosurgical congenital diaphragmatic hernia repair: a systematic review and meta-analysis. Ann Surg 2010;252:20-6.
  • McHoney M, Giacomello L, Nah SA. Thoracoscopic repair of congenital diaphragmatic hernia: intraoperative ventilation and recurrence. J Pediatr Surg 2010;45:355-9.
  • Lao OB, Crouthamel MR, Goldin AB. Thoracoscopic repair of congenital diaphragmatic hernia in infancy. J Laparoendosc Adv Surg Tech 2010;20:271-6.
  • Shah S, Wishnew J, Barsness K. Minimally invasive congenital diaphragmatic hernia repair: a 7-year review of one institution's experience. Surg Endosc 2009;23:1265- 71.
  • Guner YS, Chokshi N, Aranda A, et al. Thoracoscopic repair of neonatal diaphragmatic hernia. J Laparoendosc Adv Surg Tech 2008;18:875-80.
There are 15 citations in total.

Details

Primary Language Turkish
Journal Section Articles
Authors

Yasemin Bilgin Büyükkarabacak This is me

Burçin Çelik This is me

Aysen Taslak Sengül This is me

Selçuk Gürz This is me

Mehmet Gökhan Pirzirenli This is me

Ahmet Başoğlu This is me

Publication Date September 7, 2015
Submission Date September 7, 2015
Published in Issue Year 2015

Cite

AMA Büyükkarabacak YB, Çelik B, Sengül AT, Gürz S, Pirzirenli MG, Başoğlu A. Morgagani hernilerinin tedavisinde önce güvenlik: Transtorasik yaklaşım. Sakarya Tıp Dergisi. June 2015;5(2):65-70. doi:10.5505/sakaryamj.2015.87088

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