Laparoscopic Repair of Chronic Traumatic Diaphragmatic Hernia using Biologic Mesh with Cholecystectomy for Intrathoracic Gallbladder

Pulido, Jonathan C.; Reitz, Steven; Gozdanovic, Suzanne; Price, Phillip D.

doi:10.4293/108680811x13176785204472

Cited by 18 publications

(21 citation statements)

References 13 publications

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“…Despite the technological evolution and the great advances in imaging, CT scan may miss 30–50% of the diaphragmatic rupture during the initial assessment. 6 On the contrary, both thoracoscopic and laparoscopic approaches have been found to have both excellent diagnostic and promising therapeutic benefits. The sensitivity and the specificity almost climb up to 100% and they offer the benefit of simultaneous treatment if a diaphragmatic rupture is diagnosed.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic repair of posttraumatic diaphragmatic rupture. Report of three cases

Xenaki

Lasithiotakis

Andreou

et al. 2014

International Journal of Surgery Case Reports

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INTRODUCTIONPosttraumatic diaphragmatic rupture (PTDR) is a rare complication of thoracoabdominal injuries. In the emergency phase, it is generally treated via wide laparotomy. The laparoscopic approach is controversial and it is reserved for the chronic type of PTDR. Herein we present three cases of laparoscopic treatment of PTDR, one of which was conducted early after the injury.PRESENTATION OF CASEThe patients’ age was 42, 66 and 53 years and the time from the injury until the operation 1 week, 2 months and 4 years, respectively. Hernia involved the left hemidiaphragm in two patients and the right hemidiaphragm in the second patient. Prolapsing viscera were the omentum/stomach/spleen, the small intestine and the omentum/large bowel, respectively. The PTDR was diagnosed right after the injury of the first patient but its treatment was postponed until the fourth day of hospitalization because of severe respiratory distress due to bilateral pneumothorax, flail chest and extended bilateral lung contusions. All patients underwent laparoscopic operation and correction of the hernia with the use of non-absorbable sutures or endoclips in two patients. There were no serious intra- or postoperative complications and the patients were discharged 30, 5, 6 days after the operation. After a period of 1, 8 and 9 years, respectively the patients remain without clinical evidence of recurrence.DISCUSSIONTrauma is the major cause of acquired diaphragmatic hernias.CONCLUSIONLaparoscopy is an attractive approach for the management of chronic PTDR. Moreover, it may offer the benefits of minimally invasive surgery during the acute phase of injury in highly selected patients.

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Section: Discussionmentioning

confidence: 99%

Laparoscopic repair of posttraumatic diaphragmatic rupture. Report of three cases

Xenaki

Lasithiotakis

Andreou

et al. 2014

International Journal of Surgery Case Reports

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“…Titles and abstracts were interrogated and clinical reports on the use of biologic material for closure of traumatic diaphragmatic defects were selected. The full texts of 17 articles were assessed for eligibility; three relevant reports were identified ( 15 – 17 ). The remaining 15 articles were excluded because they reported on the use of synthetic materials in diaphragmatic rupture repair or did not provide relevant outcomes.…”

Section: Methodsmentioning

confidence: 99%

The Use of Biological Meshes in Diaphragmatic Defects – An Evidence-Based Review of the Literature

Antoniou¹,

Pointner²,

Granderath³

et al. 2015

Front. Surg.

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The widespread use of meshes for hiatal hernia repair has emerged in the era of laparoscopic surgery, although sporadic cases of mesh augmentation of traumatic diaphragmatic rupture have been reported. The indications for biologic meshes in diaphragmatic repair are ill defined. This systematic review aims to investigate the available evidence on the role of biologic meshes in diaphragmatic rupture and hiatal hernia repair. Limited data from sporadic case reports and case series have demonstrated that repair of traumatic diaphragmatic rupture with biologic mesh is safe technique in both the acute or chronic setting. High level evidence demonstrates short-term benefits of biologic mesh augmentation in hiatal hernia repair over primary repair, although adequate long-term data are not currently available. Long-term follow-up data suggest no benefit of hiatal hernia repair using porcine small intestine submucosa over suture repair. The effectiveness of different biologic mesh materials on hernia recurrence requires further investigation.

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“…La mortalidad en una reparación electiva es baja, sin embargo, la mortalidad del intestino isquémico secundario a estrangulación puede ser hasta de un El abordaje por toracoscopia o laparoscopia tiene ventajas sobre cirugía abierta, porque incluye mínimo trauma, recuperación más rápida y disminución de la estancia hospitalaria. La laparoscopia permite mejor reducción de los contenidos herniados y evaluación de ambos afragmas a la vez, mientras que la toracoscopia solamente logra inspeccionar un hemidiafragma a la vez [13].…”

Section: Manejounclassified

Hernia diafragmática post-traumática

Soto

2014

Rev.Med.UCR

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Resumen: La hernia diafragmática post historia de trauma contuso o penetrante. En algunos casos es asintomática, mientras que en estadios avanzados presenta síntomas obstructivos gastrointestinales y/o respiratorios como disnea. Debido a su heterogeneidad en las características clínicas, se debe sospechar en todo paciente con historia de trauma tóraco-abdominal. Su diagnóstico temprano es fundamental para luego proceder a su adecuado tratamiento y prevenir complicaciones. En este artículo se presenta el caso de un paciente masculino de 43 años, sin patologías previas conocidas, con antecedente de trauma penetrante en tórax, de lado izquierdo, quien un año después se presenta con cuadro de vómitos, dolor abdominal y pérdida de peso; se le realiza diagnosticaron hernia diafragmática, por lo que es llevado a sala de operaciones para su resolución quirúrgica.

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Laparoscopic Repair of Chronic Traumatic Diaphragmatic Hernia using Biologic Mesh with Cholecystectomy for Intrathoracic Gallbladder

Abstract: This report of an atypical cause of bowel obstruction suggests that laparoscopic intervention may be successfully used in the diagnosis and treatment of traumatic diaphragmatic hernia.

Cited by 18 publications

References 13 publications

Laparoscopic repair of posttraumatic diaphragmatic rupture. Report of three cases

Laparoscopic repair of posttraumatic diaphragmatic rupture. Report of three cases

The Use of Biological Meshes in Diaphragmatic Defects – An Evidence-Based Review of the Literature

Hernia diafragmática post-traumática

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