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Published on: April 17, 2019
Pediatric Morgagni hernia: A 10 year single center experience
Yasser AlFraih1, Mohammad AlDaffaa1, Tariq AlSuhaibany1
1From the Department of Surgery, College of Medicine & King Saud University Medical City, King Saud University, Riyadh, Kingdom of Saudi Arabia.
Insights
Laparoscopic repair of pediatric Morgagni hernia (MH) leads to better outcomes than open surgery. This includes shorter intensive care unit (ICU) stays and less need for mechanical ventilation, making it the preferred surgical approach.
Area of Science:
- Pediatric Surgery
- Surgical Outcomes
- Diaphragmatic Hernias
Background:
- Morgagni hernia (MH) is a rare congenital diaphragmatic defect.
- Presentation and management of pediatric MH vary.
- Optimal surgical approach requires further elucidation.
Purpose of the Study:
- To review institutional experience with pediatric Morgagni hernia (MH).
- To analyze presentation, diagnostic workup, surgical techniques, and follow-up.
- To compare outcomes of different surgical repair methods.
Main Methods:
- Retrospective chart review of 9 pediatric MH patients undergoing surgical repair (May 2014-May 2024).
- Data collected: demographics, clinical presentation, diagnostic imaging, surgical technique, and follow-up.
- Statistical analysis included Mann-Whitney U test for comparing surgical approaches.
Main Results:
- Respiratory symptoms were most common (66%).
- Laparoscopic repair (55%) showed significantly shorter ICU stays (p=0.037) and mechanical ventilation duration (p=0.020) compared to laparotomy.
- Laparotomy group had longer NPO status and hospital stay; one patient (11%) experienced MH recurrence.
Conclusions:
- Laparoscopic repair of pediatric Morgagni hernia (MH) offers superior outcomes.
- Benefits include reduced ICU days, less mechanical ventilation, decreased narcotic use, and shorter hospital stays.
- Laparoscopic repair should be the preferred method for pediatric MH when feasible and safe.
Objectives:
To present our institutional experience with pediatric morgagni hernia (MH) emphasizing the presentation, diagnostic workup, surgical techniques, and follow-up.
Methods:
A retrospective chart review of patients diagnosed with MH who underwent surgical repair from May 2014 to May 2024. Data points collected included demographic, clinical, and follow up information. We analyzed the data using basic thematic analysis. For categorical variables, we employed counts and percentages. Statistical analysis performed using the Mann-Whitney U test.
Results:
Nine patients underwent MH repair. Respiratory symptoms were the most common, affecting 66% of patients. All patients received chest radiography, while 5 required computed tomography imaging. Three (33%) patients underwent laparotomy, 5 (55%) underwent laparoscopic repair, and 1 (11%) underwent thoracotomy repair. The laparotomy group required significantly more days in the Intensive Care Unit (ICU) (p=0.037), more days on mechanical ventilation (p=0.020), and more days on IV narcotics (p=0.20). The laparotomy group experienced longer durations of NPO status and overall hospital stay. One (11%) patient experienced MH recurrence.
Conclusion:
Laparoscopic repair offers superior outcomes, such as fewer days in the ICU and on mechanical ventilation, reduced intravenous narcotic use, shorter NPO durations, and an overall shorter hospital stay. When feasible and safe, laparoscopic repair should be considered the preferred method for pediatric MH.
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