Surgery for Diaphragmatic Hernia Repair: A Longitudinal Single-Institutional Experience

Background This study analyzed and described the clinical characteristics and surgical outcomes of diaphragmatic hernia (DH) repair according to the operative approach. Methods After excluding cases with a combined approach and hiatal hernias, we analyzed 26 patients who underwent DH repair between 1994 and 2018. The baseline and perioperative characteristics of the thoracic approach group and the abdominal approach group were described and analyzed. Results Fifteen of the 26 patients were treated through the thoracic approach, including 5 patients who underwent video-assisted thoracic surgery (VATS). Eleven patients underwent the abdominal approach. The thoracic approach was associated with a longer duration of DH than the abdominal approach (2 vs. 0.1 months), herniation of the right-sided abdominal organs, and herniation of the retroperitoneal organs. During the median follow-up of 23 months, there was no recurrence of DH. Conclusion The surgical approach should be chosen considering the duration of DH and the location of herniated organs. VATS might be a safe and feasible option for repairing DH.

[1]  Alana L. Beres,et al.  Blunt Traumatic Diaphragmatic Hernia in Children: A Systematic Review. , 2021, The Journal of surgical research.

[2]  Abdullah O. Bawazir,et al.  Congenital Diaphragmatic Hernia in Neonates: Open Versus Thoracoscopic Repair , 2021, African journal of paediatric surgery : AJPS.

[3]  A. Hussain,et al.  Acute Diaphragmatic Injuries Associated with Traumatic Rib Fractures: Experiences of a Major Trauma Centre and the Importance of Intra-Pleural Assessment , 2021, Journal of chest surgery.

[4]  R. Keijzer,et al.  Congenital diaphragmatic hernia: current management strategies from antenatal diagnosis to long-term follow-up , 2020, Pediatric Surgery International.

[5]  H. Kim,et al.  A single-port video-assisted thoracoscopic surgery with CO2 insufflation for traumatic diaphragmatic hernia. , 2019, Interactive cardiovascular and thoracic surgery.

[6]  D. Boffa,et al.  Minimally Invasive Lung Cancer Surgery Performed by Thoracic Surgeons as Effective as Thoracotomy. , 2018, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[7]  A. Gurrado,et al.  Emergency surgery due to diaphragmatic hernia: case series and review , 2017, World Journal of Emergency Surgery.

[8]  A. Pierro,et al.  Advances in the surgical approach to congenital diaphragmatic hernia. , 2014, Seminars in fetal & neonatal medicine.

[9]  N. T. Liêm,et al.  Thoracoscopic approach in management of congenital diaphragmatic hernia , 2013, Pediatric Surgery International.

[10]  C. Chao,et al.  Traumatic rupture of diaphragm. , 2012, The American journal of the medical sciences.

[11]  S. Hwang,et al.  Management of Patients with Traumatic Rupture of the Diaphragm , 2011, The Korean journal of thoracic and cardiovascular surgery.

[12]  B. Louie,et al.  Chronic traumatic diaphragmatic hernia. , 2009, Thoracic surgery clinics.

[13]  S. Kaya,et al.  Clinical and Radiologic Evaluation of Foramen of Morgagni Hernias and the Transthoracic Approach , 2005, World Journal of Surgery.

[14]  D. Mathisen,et al.  Foramen of Morgagni hernia: changes in diagnosis and treatment. , 2004, The Annals of thoracic surgery.

[15]  D. Thoman,et al.  Laparoscopic diaphragmatic hernia repair , 2002, Surgical Endoscopy And Other Interventional Techniques.

[16]  K. Naunheim,et al.  Adult presentation of unusual diaphragmatic hernias. , 1998, Chest Surgery Clinics of North America.

[17]  S. Nam,et al.  Diaphragmatic hernia with isolated shoulder pain evoked by surfeit. , 2019, Annals of translational medicine.

[18]  H. Luckraz,et al.  A review diaphragmatic injury , 2009 .

[19]  T. Mineo,et al.  Transthoracic repair of Morgagni's hernia: a 20-year experience from open to video-assisted approach. , 2007, Surgical endoscopy.

[20]  V. E. Zholkver.  [Traumatic diaphragmatic hernia]. , 1954, Khirurgiia.