Ioannis Katsaros1, Stamatia Katelani2, Spyridon Giannopoulos2, Nikolaos Machairas3, Stylianos Kykalos3, Nikolaos Koliakos4, Emmanouil I Kapetanakis5, Anargyros Bakopoulos4, Dimitrios Schizas2. 1. First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, 17 Agiou Thoma Str., ZIP Code 11527, AthensAthens, Greece. ioankats@med.uoa.gr. 2. First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, 17 Agiou Thoma Str., ZIP Code 11527, AthensAthens, Greece. 3. Second Propaedeutic Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece. 4. Third Department of Surgery, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece. 5. Intensive Care Unit, Tzaneio General Hospital of Piraeus, Piraeus, Greece.
Abstract
BACKGROUND: Morgagni's hernia (MH) is defined by the protrusion of abdominal viscera through an anterior retrosternal diaphragmatic defect. The objective of this study was to systematically review current literature on MHs in adult population and assess their clinical characteristics and therapeutic approach. METHODS: PubMed and Cochrane bibliographical databases were searched (last search: 15th January 2021) for studies concerning MHs. RESULTS: Inclusion criteria were met by 189 studies that included 310 patients (61.0% females) with an age of 57.37 ± 18.41 (mean ± SD) years. Pulmonary symptoms, abdominal pain, and nausea-vomit were among the most frequent symptomatology. MHs were predominantly right-sided (84.0%), with greater omentum (74.5%) and transverse colon (65.1%) being the most commonly herniated viscera. The majority of cases underwent an open procedure, while 42.3% of patients had a minimally invasive procedure. Abdominal approach was mostly preferred, while a thoracic one was chosen at 20.6% of cases and a thoracoabdominal at 3.2%. Thirty-day postoperative complications were recorded at 29 patients and 30-day mortality was 2.3%. CONCLUSIONS: MH is a rare type of congenital diaphragmatic hernia which rarely manifests in adult population with atypical pulmonary and gastrointestinal symptoms. Surgery is the gold standard for their management. Open surgical approach is preferable in emergency cases, while laparoscopic surgery is favored in elective setting and is associated with shorter hospitalization. Further studies are crucial in order to elucidate etiology and optimal therapeutic approach.
BACKGROUND: Morgagni's hernia (MH) is defined by the protrusion of abdominal viscera through an anterior retrosternal diaphragmatic defect. The objective of this study was to systematically review current literature on MHs in adult population and assess their clinical characteristics and therapeutic approach. METHODS: PubMed and Cochrane bibliographical databases were searched (last search: 15th January 2021) for studies concerning MHs. RESULTS: Inclusion criteria were met by 189 studies that included 310 patients (61.0% females) with an age of 57.37 ± 18.41 (mean ± SD) years. Pulmonary symptoms, abdominal pain, and nausea-vomit were among the most frequent symptomatology. MHs were predominantly right-sided (84.0%), with greater omentum (74.5%) and transverse colon (65.1%) being the most commonly herniated viscera. The majority of cases underwent an open procedure, while 42.3% of patients had a minimally invasive procedure. Abdominal approach was mostly preferred, while a thoracic one was chosen at 20.6% of cases and a thoracoabdominal at 3.2%. Thirty-day postoperative complications were recorded at 29 patients and 30-day mortality was 2.3%. CONCLUSIONS: MH is a rare type of congenital diaphragmatic hernia which rarely manifests in adult population with atypical pulmonary and gastrointestinal symptoms. Surgery is the gold standard for their management. Open surgical approach is preferable in emergency cases, while laparoscopic surgery is favored in elective setting and is associated with shorter hospitalization. Further studies are crucial in order to elucidate etiology and optimal therapeutic approach.
Authors: Zachary Sanford; Adam S Weltz; Jermaine Brown; Nicole Shockcor; Nan Wu; Adrian E Park Journal: Surg Innov Date: 2018-05-29 Impact factor: 2.058
Authors: Massimo Garriboli; Mark Bishay; Edward M Kiely; David P Drake; Joseph I Curry; Kate M K Cross; Simon Eaton; Paolo De Coppi; Agostino Pierro Journal: Pediatr Surg Int Date: 2013-02 Impact factor: 1.827