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Transthoracic approach in surgical management of Morgagni hernia
1Department of Thoracic Surgery, Ankara University, School of Medicine, 06100 Sihhiye, Ankara, Turkey.
Objective:
Morgagni hernia is an uncommon type of diaphragmatic hernias. Numerous approaches have been described and, particularly the significance of laparatomy has been emphasized as an operative technique. We present our experience on patients with Morgagni hernia operated on via transthoracic approach in our department.
Materials And Methods:
Between January 1986 and March 2000, 16 patients with Morgagni hernia were operated in our department. Their ages ranged from 16 to 68 years (mean 51.5). Five (31.25%) patients were male, and 11 (68.75%) patients were female. Chest roentgenograms, thorax CT, barium enema roentgenographic studies were used as diagnostic utilities. Right posterolateral thoracotomy was performed in all patients.
Results:
Hernia sac was present in all cases. Exploration revealed omentum in hernia sac in eight patients (50%), colon and omentum in seven patients (44%), only colon in one patient (%6). Postoperative course was uneventful. The mean follow-up was 5.7 years. There was no recurrence or symptoms related to the operation.
Conclusions:
We advocate transthoracic approach for surgical exposure as it provides wide exposure and easy repair of the hernia sac in Morgagni hernia.
Insights
The transthoracic approach is effective for Morgagni hernia repair, offering wide surgical exposure and easy sac repair. This method resulted in no recurrence in a 5.7-year follow-up for 16 patients.
Area of Science:
- Surgery
- Thoracic Surgery
- Gastroenterology
Background:
- Morgagni hernia is a rare diaphragmatic defect.
- Various surgical techniques exist, with laparotomy often highlighted.
- Transthoracic approach for Morgagni hernia is less commonly detailed.
Purpose of the Study:
- To present surgical experience with Morgagni hernia using a transthoracic approach.
- To evaluate the efficacy and outcomes of this surgical technique.
Main Methods:
- Retrospective analysis of 16 patients operated for Morgagni hernia between 1986 and 2000.
- Diagnostic tools included chest X-ray, CT scans, and barium enema.
- All patients underwent right posterolateral thoracotomy.
Main Results:
- Hernia sac contents varied, commonly omentum and/or colon.
- All postoperative courses were uneventful.
- Mean follow-up of 5.7 years showed no recurrence or operation-related symptoms.
Conclusions:
- The transthoracic approach provides excellent surgical exposure for Morgagni hernia.
- This technique facilitates straightforward repair of the hernia sac.
- Transthoracic approach is advocated for Morgagni hernia management.