Yasemin Bilgin Büyükkarabacak, Burçin Çelik, Aysen Taslak Sengül, Selçuk Gürz, Mehmet Gökhan Pirzirenli, Ahmet Başoğlu

Morgagani hernilerinin tedavisinde önce güvenlik: Transtorasik yaklaşım

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.

Anahtar Kelimeler:

Morgagni, diyafram, herni, torakotomi

Firstly safety to treatment of morgagni hernia: Transthoracic apporach

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.

Keywords:

Morgagni, Diaphragm, Hernia, Thoracotomy,

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