TITLE

Abdominal Approach to Chronic Diaphragmatic Hernias: Is It Safe?

AUTHOR(S)
Murray, James A.; Weng, Janie; Velmahos, George C.; Demetriades, Demetrios
PUB. DATE
October 2004
SOURCE
American Surgeon;Oct2004, Vol. 70 Issue 10, p897
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Standard teaching has been to approach chronic diaphragmatic hernias (CDH) via a thoracotomy. It has been our experience that CDH can be safely approached via an abdominal incision. The objective of this study was to evaluate the outcome of patients undergoing the transabdominal approach for repair of CDH and comparing the outcome with that of patients undergoing a transthoracic (TT) approach. This is a retrospective chart review and was performed of patients with CDH secondary to trauma. Patient demographics, presenting symptoms, operative approach, and complications were collected. Patients were stratified by the surgical approach, TA versus TT. The endpoints of analysis were need for second incision, intraoperative and postoperative complications (enterotomies, pneumonia), need for a chest tube, mechanical ventilation postoperatively, and ICU and hospital days. Twenty-eight patients with CDH repairs performed between Jan 1993 and Dec 2002 were identified. Nineteen patients were in the TA group, and nine were in the TT group. Patients in the TA group had a higher incidence of emergent surgery (68% vs 11%, P = 0.005) and had a lower incidence of postoperative pneumonia (0% vs 33%, P = 0.009). No case of enteric injury from lysis of adhesions in the chest was identified. The need for a second incision (11%), the mortality (11%), ICU stay, and hospital stay were the same between the two groups. It appears that repair of CDH can be performed safely through an abdominal approach.
ACCESSION #
14698327

 

Related Articles

  • Incidence of incisional hernia following vertical banded gastroplasty. Arribas, D.; Elía, M.; Artigas, C.; Jiménez, A.; Aguilella, V.; Martínez, M.; Elía, M; Jiménez, A; Martínez, M // Hernia;May2004, Vol. 8 Issue 2, p135 

    Background: Our aim was to determine which patient-related factors influence the incidence of incisional hernia after vertical banded gastroplasty for morbid obesity.Methods: We reviewed the medical records of 80 morbidly obese patients operated on between 1986 and...

  • Promising new technique in the repair of parastomal hernia. Hansson, B. M. E.; van Nieuwenhoven, E. J.; Bleichrodt, R. P. // Surgical Endoscopy;Nov2003, Vol. 17 Issue 11, p1789 

    Parastomal hernia is a common complication after stoma formation. Although not all hernias require surgical repair, a variety of surgical techniques exist. Fascial repair, relocation of the stoma, and the local use of a nonabsorbable mesh are the three major approaches. Despite this variety of...

  • The obturator hernia: difficult to diagnose, easy to repair. Shipkov, C.D.; Uchikov, A.P.; Grigoriadis, E. // Hernia;May2004, Vol. 8 Issue 2, p155 

    Background: The aim of this paper is to present a simple method for obturator hernia repair in two cases with strangulated obturator hernia.Methods: The authors report on two cases of mechanical bowel obstruction due to incarcerated obturator hernia in elderly, thin...

  • Association of facet tropism with lumbar disc herniation. Chadha, Manish; Sharma, Gaurav; Arora, Shobha; Kochar, Vivek // European Spine Journal;May2013, Vol. 22 Issue 5, p1045 

    Purpose: Facet tropism is defined as asymmetry between left and right facet joints and is postulated as a possible cause of disc herniation. In the present study, the authors used a 3-T MRI to investigate the association between facet tropism and lumbar disc herniation at a particular motion...

  • Groin Hernia Repair: Open Techniques. Amid, Parviz K. // World Journal of Surgery;Aug2005, Vol. 29 Issue 8, p1046 

    Since the introduction of the Bassini method in 1887, more than 70 types of pure tissue repair have been reported in the surgical literature. An unacceptable recurrence rate and prolonged postoperative pain and recovery time after tissue repair along with our understanding of the metabolic...

  • Endoscopic total extraperitoneal management of Amyand's hernia. Saggar, V.R.; Singh, K.; Sarangi, R. // Hernia;May2004, Vol. 8 Issue 2, p164 

    Presence of an appendix in a hernial sac (Amyand's hernia) is a rare entity, still rarer is an inflamed appendix within the hernial sac. An endoscopic total extraperitoneal repair of a right-sided incarcerated inguinal hernia is described. The inguinal hernial sac contained an inflamed appendix....

  • The posterior (preperitoneal) approach and iliopubic tract repair of inguinal and femoral hernias - an update. Nyhus, Lloyd M. // Hernia;Jun2003, Vol. 7 Issue 2, p63 

    This article presents information about pioneer in hernia surgery. Lloyd Milton Nyhus's nascent interest in science and medicine were an extension of the caring and nurturing philosophy of his parents. However, Dr. Nyhus set about the task of reorganizing the Department of Surgery with the same...

  • Amyand's hernia-a vermiform appendix presenting in an inguinal hernia: a case series.  // Journal of Medical Case Reports;2011, Vol. 5 Issue 1, p463 

    The article presents the case of an amyand's hernia-a vermiform appendix in an inguinal hernia. In this case, histories of 963 Caucasian patients with inguinal hernia, admitted and treated over 12-year period was considered. Acute appendicitis within an inguinal hernia accounts for 0.1% of all...

  • Recurrences after laparoscopic ventral hernia repair: results and critical review. Sánchez, L.J.; Bencini, L.; Moretti, R.; Sánchez, L J // Hernia;May2004, Vol. 8 Issue 2, p138 

    We describe the whole cohort of patients operated on laparoscopically for ventral hernias at our institution. Information on early results, complications, and long-term follow-up was collected prospectively. Of 90 operations attempted, five (5.8%) required conversion. Of the remaining 85...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics