Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica · 2025
Laparoscopic repair of Morgagni hernia in children: Tips and tricks learned in 20 years' experience at a tertiary pediatric center.
СтатьяНазвание и аннотация: Перевод в очереди
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Ortiz R J, Ruiz J, Andrade Manso M, Reusmann A, Boglione M M, Giuseppucci C, Pérez Espinosa C M, Canestrari S, Capparelli M, Korman L, Redondo E J, Giubergia V, Ayarzabal V H, Barrenechea M E
Аннотация
OBJECTIVE: Morgagni hernia (MH) is a congenital diaphragmatic defect located in the retrosternal region. This study aims to report and analyze 20 years of experience in the diagnosis and management of MH at a tertiary pediatric center.
MATERIAL AND METHODS: We conducted a retrospective review of patients who underwent laparoscopic MH repair between 2002 and 2022. Data on symptoms, defect location, surgical techniques, complications, and recurrences were analyzed.
RESULTS: Fifty-five children were included in the study. Thirty-two (58%) were male. Mean age at surgery was 36 months (3 days-11 years). Mean follow-up was 45.16 months (8-110 months). Most hernias were discovered incidentally (61.8%). Nineteen patients (34.6%) had upper respiratory tract symptoms and a history of recurrent lung infection. Two patients (3.6%) presented with intestinal occlusion. Fifteen patients (27.2%) had Down syndrome, and seven (12.7%) had cardiac defects. The repair technique involved transabdominal laparoscopic-assisted repair with percutaneous sutures and extracorporeal knotting. Reoperation due to recurrence was necessary in two patients (3.6%), one of whom needed two redo procedures.
CONCLUSIONS: The transabdominal laparoscopic-assisted technique with percutaneous sutures and extracorporeal knotting is effective for MH repair, offering a low recurrence rate and minimal complications. Emphasizing the technical aspects, including tips and tricks, may further benefit the readership.
MATERIAL AND METHODS: We conducted a retrospective review of patients who underwent laparoscopic MH repair between 2002 and 2022. Data on symptoms, defect location, surgical techniques, complications, and recurrences were analyzed.
RESULTS: Fifty-five children were included in the study. Thirty-two (58%) were male. Mean age at surgery was 36 months (3 days-11 years). Mean follow-up was 45.16 months (8-110 months). Most hernias were discovered incidentally (61.8%). Nineteen patients (34.6%) had upper respiratory tract symptoms and a history of recurrent lung infection. Two patients (3.6%) presented with intestinal occlusion. Fifteen patients (27.2%) had Down syndrome, and seven (12.7%) had cardiac defects. The repair technique involved transabdominal laparoscopic-assisted repair with percutaneous sutures and extracorporeal knotting. Reoperation due to recurrence was necessary in two patients (3.6%), one of whom needed two redo procedures.
CONCLUSIONS: The transabdominal laparoscopic-assisted technique with percutaneous sutures and extracorporeal knotting is effective for MH repair, offering a low recurrence rate and minimal complications. Emphasizing the technical aspects, including tips and tricks, may further benefit the readership.