...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Surgical Endoscopy >Thoracoscopic repair of congenital diaphragmatic hernia: a new anatomical reconstructive concept for tension dispersal at primary closure
【24h】

Thoracoscopic repair of congenital diaphragmatic hernia: a new anatomical reconstructive concept for tension dispersal at primary closure

机译：先天性膈疝的胸腔镜修复：初级闭合张力分散的新解剖学重建概念

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Background Several measures were implemented among authors striving to tail off recurrence rates of thoracoscopic congenital diaphragmatic hernia repair. In the presented study, we extended the use of rib-anchoring stitches to reorient the diaphragmatic muscle leaflets in the types B&C diaphragmatic hernias, to achieve tension dispersal at primary thoracoscopic repair. Patients and methods Included in this study were early and late-onset lateral congenital diaphragmatic hernia patients, who had been operated upon in the years 2012 through 2018. A preliminary stitch was taken between posterior muscle edge and rib cage to reorient the diaphragmatic defect into a reversed C-shaped line. The lateral portion was closed by additional rib-anchoring stitches, while the medial one necessitated muscle to muscle stitches. Primary outcome being validated was the recurrence rate within a year post repair. Results In the 7-year inclusion period, 36 congenital diaphragmatic hernia cases were managed using the described approach. The repair was accomplished thoracoscopically in all but two cases, who were excluded from the study. Mean operative time was 76 min. No pledgets or synthetic patches were applied. Mean length of hospital stay was 7.6 days. Early postoperative course was uneventful in all but four cases; two ventilatory barotrauma and two mortalities. After a mean follow-up period of 29 months, five recurrences were reported (16%). Ipsilateral chest wall deformity was noticed in one case 3 years post repair. Conclusion In the presented study, authors adopted thoracoscopic reorientation of diaphragmatic muscle leaflets in lateral congenital diaphragmatic hernia cases to achieve tension dispersal at primary repair. Short and mid-term results supported the efficacy and reproducibility of the described approach. However, long-term comparative studies seemed a necessity to validate this outcome.
机译：背景：在努力降低胸腔镜下先天性膈疝修补术复发率的作者中实施了几项措施。在本研究中，我们在B型和C型膈疝中扩大了肋骨锚定缝合的使用范围，以调整膈肌小叶的方向，从而在初次胸腔镜修补术中实现张力分散。本研究纳入的患者和方法为早发型和晚发型先天性侧膈疝患者，他们于2012年至2018年接受手术治疗。在后肌边缘和胸腔之间进行初步缝合，以将膈肌缺损重新定位为反向C形线。外侧部分用额外的肋骨锚定缝线缝合，内侧部分则需要肌肉间缝线。正在验证的主要结果是修复后一年内的复发率。结果在7年的纳入期内，36例先天性膈疝采用上述方法治疗。除两例被排除在研究之外，其余病例均在胸腔镜下完成修复。平均手术时间为76分钟。未使用质膜或合成补片。平均住院时间为7.6天。除4例外，所有患者术后早期病程均无异常；两次通气性气压伤和两次死亡。平均随访29个月后，有5例复发（16%）。1例修复后3年出现同侧胸壁畸形。结论在本研究中，作者在侧位先天性膈疝患者中采用胸腔镜下膈肌小叶重新定向，以实现一期修复时的张力分散。短期和中期结果支持所述方法的有效性和再现性。然而，长期的比较研究似乎有必要验证这一结果。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号