Management of complicated diaphragmatic hernia in the acute setting: a WSES position paper

被引：25

作者：

Giuffrida, Mario ^{[1
]}

Perrone, Gennaro ^{[2
]}

Abu-Zidan, Fikri ^{[3
]}

Agnoletti, Vanni ^{[4
]}

Ansaloni, Luca ^{[5
]}

Baiocchi, Gian Luca ^{[6
]}

Bendinelli, Cino ^{[7
]}

Biffl, Walter L. ^{[8
]}

Bonavina, Luigi ^{[9
]}

Bravi, Francesca ^{[10
]}

Carcoforo, Paolo ^{[11
,12
]}

Ceresoli, Marco ^{[13
]}

Chichom-Mefire, Alain ^{[14
]}

Coccolini, Federico ^{[15
]}

Coimbra, Raul ^{[16
]}

de'Angelis, Nicola ^{[17
]}

de Moya, Marc ^{[18
]}

De Simone, Belinda ^{[19
]}

Di Saverio, Salomone ^{[20
]}

Fraga, Gustavo Pereira ^{[21
]}

Galante, Joseph ^{[22
]}

Ivatury, Rao ^{[23
]}

Kashuk, Jeffry ^{[24
]}

Kelly, Michael Denis ^{[25
]}

Kirkpatrick, Andrew W. ^{[26
]}

Kluger, Yoram ^{[27
]}

Koike, Kaoru ^{[28
]}

Leppaniemi, Ari ^{[29
]}

Maier, Ronald V. ^{[30
]}

Moore, Ernest Eugene ^{[31
]}

Peitzmann, Andrew ^{[32
]}

Sakakushev, Boris ^{[33
]}

Sartelli, Massimo ^{[34
]}

Sugrue, Michael ^{[35
]}

Tian, Brian W. C. A. ^{[36
]}

Ten Broek, Richard ^{[37
]}

Vallicelli, Carlo ^{[4
]}

Wani, Imtaz ^{[38
]}

Weber, Dieter G. ^{[39
]}

Docimo, Giovanni ^{[40
]}

Catena, Fausto ^{[4
]}

机构：

[1] Maggiore Hosp, Gen Surg Unit, Parma, Italy

[2] Maggiore Hosp, Dept Emergency Surg, Via A Gramsci 14, I-43126 Parma, Italy

[3] UAE Univ, Coll Med & Hlth Sci, Res Off, Al Ain, U Arab Emirates

[4] Bufalini Hosp, Emergency & Trauma Surg, Cesena, Italy

[5] IRCCS Policlin San Matteo Fdn, Dept Gen Surg, Pavia, Italy

[6] Univ Brescia, Dept Clin & Expt Sci, Gen Surg, Brescia, Italy

[7] Univ Newcastle, John Hunter Hosp, Newcastle, NSW, Australia

[8] Univ Hawaii, Acute Care Surg, John A Burns Sch Med, Queens Med Ctr, Honolulu, HI USA

[9] Univ Milan, Dept Gen & Foregut Surg, IRCCS Policlin San Donato, Milan, Italy

[10] AUSL Romagna, Santa Maria Delle Croci Hosp, Healthcare Adm, Ravenna, Italy

[11] Univ Hosp Ferrara, Dept Morphol Surg & Expt Med, Ferrara, Italy

[12] Univ Ferrara, Ferrara, Italy

[13] Milano Bicocca Univ, Sch Med & Surg, Gen & Emergency Surg, Monza, Italy

[14] Reg Hosp, Dept Surg & Obstet Gynaecol, Limbe, Cameroon

[15] Pisa Univ Hosp, Gen Emergency & Trauma Surg Dept, Pisa, Italy

[16] Riverside Univ Hlth Syst Med Ctr, Riverside, CA USA

[17] Univ of Paris Cite, Beaujon Univ Hosp, AP HP, Unit Colorectal & Digest Surg,DIGEST Dept, Clichy, France

[18] Med Coll Wisconsin, Dept Surg, Trauma Acute Care Surg, Milwaukee, WI USA

[19] Poissy & St Germain En Laye Hosp, Dept Gen & Metab Surg, Poissy, France

[20] San Benedetto Tronto Gen Hosp, Dept Gen Surg, San Benedetto Tronto, Italy

[21] Univ Campinas Unicamp, Sch Med Sci, Dept Surg, Div Trauma Surg, Campinas, SP, Brazil

[22] Univ Calif Davis, Trauma Dept, Sacramento, CA USA

[23] Virginia Commonwealth Univ, Dept Surg, Sch Med, Richmond, VA USA

[24] Tel Aviv Univ, Sackler Sch Med, Dept Surg, Tel Aviv, Israel

[25] Albury Hosp, Dept Gen Surg, Albury, Australia

[26] Foothills Med Ctr, Dept Gen Acute Care Abdominal Wall Reconstruct &, Calgary, AB, Canada

[27] Rambam Hlth Care Campus, Dept Gen Surg, Div Surg, Haifa, Israel

[28] Kyoto Univ, Dept Primary Care & Emergency Med, Grad Sch Med, Kyoto, Japan

[29] Univ Hosp Meilahti, Abdominal Ctr, Helsinki, Finland

[30] Univ Washington, Dept Surg, Seattle, WA USA

[31] Univ Colorado, Denver Hlth Med Ctr, Dept Surg, Denver, CO USA

[32] Univ Pittsburgh, Sch Med, Pittsburgh, PA USA

[33] Med Univ, Gen Surg Dept, Univ Hosp St George, Plovdiv, Bulgaria

[34] Macerata Hosp, Dept Surg, Macerata, Italy

[35] Letterkenny Univ Hosp, Dept Surg, Letterkenny, Donegal, Ireland

[36] Singapore Gen Hosp, Dept Gen Surg, Singapore, Singapore

[37] Radboud Univ Nijmegen Med Ctr, Surg Dept, Nijmegen, Netherlands

[38] Govt Gousia Hosp, Dept Minimal Access & Gen Surg, Srinagar, India

[39] Royal Perth Hosp, Dept Trauma Surg, Perth, Australia

[40] Univ Campania Luigi Vanvitelli, Dept Med & Adv Surg Sci, Naples, Italy

来源：

WORLD JOURNAL OF EMERGENCY SURGERY | 2023年 / 18卷 / 01期

关键词：

Diaphragm hernia; Emergency surgery; Guidelines; Rupture; Trauma; Congenital; PARA-ESOPHAGEAL HERNIA; BOCHDALEK HERNIA; MORGAGNI HERNIA; GASTROESOPHAGEAL-REFLUX; LAPAROSCOPIC REPAIR; GASTRIC VOLVULUS; INTRATHORACIC STOMACH; PENETRATING INJURIES; TRAUMATIC INJURIES; PRENATAL-DIAGNOSIS;

D O I：

10.1186/s13017-023-00510-x

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

BackgroundDiaphragmatic hernia (DH) presenting acutely can be a potentially life-threatening condition. Its management continues to be debatable.MethodsA bibliographic search using major databases was performed using the terms "emergency surgery" "diaphragmatic hernia," "traumatic diaphragmatic rupture" and "congenital diaphragmatic hernia." GRADE methodology was used to evaluate the evidence and give recommendations.ResultsCT scan of the chest and abdomen is the diagnostic gold standard to evaluate complicated DH. Appropriate preoperative assessment and prompt surgical intervention are important for a clinical success. Complicated DH repair is best performed via the use of biological and bioabsorbable meshes which have proven to reduce recurrence. The laparoscopic approach is the preferred technique in hemodynamically stable patients without significant comorbidities because it facilitates early diagnosis of small diaphragmatic injuries from traumatic wounds in the thoraco-abdominal area and reduces postoperative complications. Open surgery should be reserved for situations when skills and equipment for laparoscopy are not available, where exploratory laparotomy is needed, or if the patient is hemodynamically unstable. Damage Control Surgery is an option in the management of critical and unstable patients.ConclusionsComplicated diaphragmatic hernia is a rare life-threatening condition. CT scan of the chest and abdomen is the gold standard for diagnosing the diaphragmatic hernia. Laparoscopic repair is the best treatment option for stable patients with complicated diaphragmatic hernias. Open repair is considered necessary in majority of unstable patients in whom Damage Control Surgery can be life-saving.

引用

页数：12

共 149 条

[61] Management of Morgagni's Hernia in the Adult Population: A Systematic Review of the Literature [J].