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Sano A, Azuma Y, Sakai T, Koezuka S, Otsuka H, Iyoda A. Diaphragm reconstruction by GORE DUALMESH in patients undergoing resection for thoracic malignancies. J Cardiothorac Surg 2021; 16:65. [PMID: 33789706 PMCID: PMC8011125 DOI: 10.1186/s13019-021-01449-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 03/23/2021] [Indexed: 11/15/2022] Open
Abstract
Background We used GORE DUALMESH for the reconstruction of diaphragms in patients with thoracic malignancies. Here, we report the results. Methods Between July 2015 and August 2017, diaphragm reconstruction using 2-mm GORE DUALMESH was performed in 7 patients undergoing surgical resection for thoracic malignancies. After resection of the diaphragm, the mesh was trimmed to the size of defect and placed with the smooth surface facing the chest cavity and the rough surface facing the abdomen. It was fixed with interrupted sutures consisting of synthetic monofilament nonabsorbable 1–0 to 2 threads. Results Indications for resection were malignant pleural mesothelioma and primary lung cancer in 5 and 2 patients, respectively. Patients with malignant pleural mesothelioma underwent pleurectomy with decortication; patients with primary lung cancer underwent lung lobectomy. Right and left diaphragm reconstruction was performed for 4 and 3 patients, respectively. Neither complications related to diaphragm reconstruction nor displacement of mesh occurred during a follow-up period ranging from 11 days to 37 months. Conclusions GORE DUALMESH is a good synthetic material for diaphragm reconstruction, because its smooth surface prevents adhesions to the lung and its rough surface allows adherence to abdominal tissue.
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Affiliation(s)
- Atsushi Sano
- Division of Chest Surgery, Toho University School of Medicine, 6-11-1 Omori-nishi, Ota-ku, Tokyo, 143-8541, Japan
| | - Yoko Azuma
- Division of Chest Surgery, Toho University School of Medicine, 6-11-1 Omori-nishi, Ota-ku, Tokyo, 143-8541, Japan
| | - Takashi Sakai
- Division of Chest Surgery, Toho University School of Medicine, 6-11-1 Omori-nishi, Ota-ku, Tokyo, 143-8541, Japan
| | - Satoshi Koezuka
- Division of Chest Surgery, Toho University School of Medicine, 6-11-1 Omori-nishi, Ota-ku, Tokyo, 143-8541, Japan
| | - Hajime Otsuka
- Division of Chest Surgery, Toho University School of Medicine, 6-11-1 Omori-nishi, Ota-ku, Tokyo, 143-8541, Japan
| | - Akira Iyoda
- Division of Chest Surgery, Toho University School of Medicine, 6-11-1 Omori-nishi, Ota-ku, Tokyo, 143-8541, Japan.
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An B, Zen Y, Akabori H, Kitamura N, Ohta H, Otsuki A, Mizuta H, Tsujikawa T, Mekata E. Gastric volvulus and giant Bochdalek hernia in an adult patient that were safely repaired by endoscopic reduction and elective laparoscopic surgery. Asian J Endosc Surg 2021; 14:120-123. [PMID: 32484304 DOI: 10.1111/ases.12806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 03/24/2020] [Accepted: 03/29/2020] [Indexed: 11/29/2022]
Abstract
A Bochdalek hernia (BH) is a congenital abnormality with incomplete closure of the diaphragm. It is usually manifested in infants but rarely in adults. Here, we report an adult patient with gastric volvulus and giant BH that were safely repaired by endoscopic reduction and elective laparoscopic surgery, respectively. A 79-year-old woman presented with left upper abdominal pain but no history of trauma. CT revealed a giant BH with gastric volvulus. After emergency endoscopic reduction of the volvulus, elective laparoscopic repair of the BH was performed. The 8 × 8-cm defect was repaired with interrupted nonabsorbable sutures and a mesh. The patient's postoperative course was uneventful, and no complications or recurrence were observed in the 6 months that followed.
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Affiliation(s)
- Byonggu An
- Department of Surgery, Higashi-Ohmi General Medical Center, Higashiomi, Japan
| | - Yumi Zen
- Department of Surgery, Higashi-Ohmi General Medical Center, Higashiomi, Japan
| | - Hiroya Akabori
- Department of Surgery, Higashi-Ohmi General Medical Center, Higashiomi, Japan
| | - Naomi Kitamura
- Department of Surgery, Higashi-Ohmi General Medical Center, Higashiomi, Japan
| | - Hiroyuki Ohta
- Department of Surgery, Higashi-Ohmi General Medical Center, Higashiomi, Japan
| | - Akinori Otsuki
- Department of Gastroenterological Medicine, Higashi-Ohmi General Medical Center, Higashiomi, Japan
| | - Hiroo Mizuta
- Department of Gastroenterological Medicine, Higashi-Ohmi General Medical Center, Higashiomi, Japan
| | - Tomoyuki Tsujikawa
- Department of Gastroenterological Medicine, Higashi-Ohmi General Medical Center, Higashiomi, Japan
| | - Eiji Mekata
- Department of Surgery, Higashi-Ohmi General Medical Center, Higashiomi, Japan
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Miyasaka T, Matsutani T, Nomura T, Hagiwara N, Chihara N, Takahashi K, Mishima K, Taniai N, Yoshida H. Laparoscopic repair of a Bochdalek hernia in an elderly patient: a case report with a review from 1999 to 2019 in Japan. Surg Case Rep 2020; 6:233. [PMID: 32990881 PMCID: PMC7524921 DOI: 10.1186/s40792-020-01003-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 09/18/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A Bochdalek hernia (BH) is a congenital defect of the diaphragm that generally presents in the newborn as life-threatening cardiorespiratory distress. In contrast, the diagnosis of a BH in adults is rare. Surgical repair for adult BH is recommended, but the optimal surgical method remains unclear. CASE PRESENTATION A 75-year-old woman presented with progressive dyspnea and back pain, and a diagnosis of BH was made based on chest X-ray and computed tomography. Laparoscopic evaluation revealed a defect in the left posterior attachment of the diaphragm, and a left-sided BH without hernia sac was diagnosed. Parts of the stomach, small intestine, colon, pancreas, and spleen had prolapsed into the left thoracic cavity, without ischemic change, and these herniated organs were reduced to the abdominal cavity. A direct closure of the hernia orifice was possible by the laparoscopic suture technique using a mesh reinforcement. The patient made an uneventful recovery, and no recurrence was found in the 2-year follow-up. CONCLUSION A recently published study reviewing detailed cases of repair of adult BH from 1999 to 2019 identified 96 cases, including the present case. The number of reports on laparoscopic and/or thoracoscopic surgery for BH in adults has recently increased, and the approach for repairing BH should be selected carefully on a case-by-case basis.
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Affiliation(s)
- Toshimitsu Miyasaka
- Department of Gastrointestinal Hepato-Biliary-Pancreatic Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan
| | - Takeshi Matsutani
- Department of Gastrointestinal Hepato-Biliary-Pancreatic Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan. .,Department of Digestive Surgery, Nippon Medical School Musashikosugi Hospital, 1-396 Kosugimachi, Nakahara-ku, Kawasaki-shi, Kanagawa, 211-8533, Japan.
| | - Tsutomu Nomura
- Department of Gastrointestinal Hepato-Biliary-Pancreatic Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan
| | - Nobutoshi Hagiwara
- Department of Gastrointestinal Hepato-Biliary-Pancreatic Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan
| | - Naoto Chihara
- Department of Digestive Surgery, Nippon Medical School Musashikosugi Hospital, 1-396 Kosugimachi, Nakahara-ku, Kawasaki-shi, Kanagawa, 211-8533, Japan
| | - Koichi Takahashi
- Department of Digestive Surgery, Nippon Medical School Musashikosugi Hospital, 1-396 Kosugimachi, Nakahara-ku, Kawasaki-shi, Kanagawa, 211-8533, Japan
| | - Keisuke Mishima
- Department of Digestive Surgery, Nippon Medical School Musashikosugi Hospital, 1-396 Kosugimachi, Nakahara-ku, Kawasaki-shi, Kanagawa, 211-8533, Japan
| | - Nobuhiko Taniai
- Department of Digestive Surgery, Nippon Medical School Musashikosugi Hospital, 1-396 Kosugimachi, Nakahara-ku, Kawasaki-shi, Kanagawa, 211-8533, Japan
| | - Hiroshi Yoshida
- Department of Gastrointestinal Hepato-Biliary-Pancreatic Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan
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Akita M, Yamasaki N, Miyake T, Mimura K, Maeda E, Nishimura T, Abe K, Kozuki A, Yokoyama K, Kominami H, Tanaka T, Takamatsu M, Kaneda K. Bochdalek hernia in an adult: two case reports and a review of perioperative cardiopulmonary complications. Surg Case Rep 2020; 6:72. [PMID: 32303918 PMCID: PMC7165220 DOI: 10.1186/s40792-020-00833-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 04/02/2020] [Indexed: 11/10/2022] Open
Abstract
Background Bochdalek hernia in an adult is very rare and often needs an immediate surgical repair for the herniation. Although its etiology and surgical techniques have frequently been reported, perioperative complications, especially cardiopulmonary problems, remain unknown. We reported two adults with Bochdalek hernia and reviewed the published literatures with a focus on these issues. Case presentation We experienced two adult cases of Bochdalek hernia with gastrointestinal strangulation. One case had massive herniation of the stomach, colon, spleen, and pancreas in the left chest, causing repeated vomiting. The other had a right-side hernia with strangulation of the colon. We successfully performed emergency repairs of these diaphragmatic hernias without any postoperative complications. Conclusions Our literature review revealed that life-threatening cardiopulmonary complications, such as empyema or cardiac arrest caused by the tamponade effect of the herniated viscera, sometimes occurred in patients with Bochdalek hernia. These complications were found in Bochdalek hernia with gastrointestinal strangulation.
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Affiliation(s)
- Masayuki Akita
- Department of Surgery, Kakogawa Central City Hospital, Kakogawa, 675-8611, Japan.
| | - Nobuaki Yamasaki
- Department of Surgery, Kakogawa Central City Hospital, Kakogawa, 675-8611, Japan
| | - Taiichiro Miyake
- Department of Surgery, Kakogawa Central City Hospital, Kakogawa, 675-8611, Japan
| | - Kazuya Mimura
- Department of Surgery, Kakogawa Central City Hospital, Kakogawa, 675-8611, Japan
| | - Eri Maeda
- Department of Surgery, Kakogawa Central City Hospital, Kakogawa, 675-8611, Japan
| | - Tohru Nishimura
- Department of Surgery, Kakogawa Central City Hospital, Kakogawa, 675-8611, Japan
| | - Koichiro Abe
- Department of Surgery, Kakogawa Central City Hospital, Kakogawa, 675-8611, Japan
| | - Akihito Kozuki
- Department of Surgery, Kakogawa Central City Hospital, Kakogawa, 675-8611, Japan
| | - Kunio Yokoyama
- Department of Surgery, Kakogawa Central City Hospital, Kakogawa, 675-8611, Japan
| | - Hiroaki Kominami
- Department of Surgery, Kakogawa Central City Hospital, Kakogawa, 675-8611, Japan
| | - Tomohiro Tanaka
- Department of Surgery, Kakogawa Central City Hospital, Kakogawa, 675-8611, Japan
| | - Manabu Takamatsu
- Department of Surgery, Kakogawa Central City Hospital, Kakogawa, 675-8611, Japan
| | - Kunihiko Kaneda
- Department of Surgery, Kakogawa Central City Hospital, Kakogawa, 675-8611, Japan
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Matsudera S, Nakajima M, Takahashi M, Muroi H, Kikuchi M, Shida Y, Ihara K, Yamaguchi S, Sasaki K, Tsuchioka T, Kato H. Laparoscopic surgery for a Bochdalek hernia triggered by pregnancy in an adult woman: A case report. Int J Surg Case Rep 2018; 48:10-15. [PMID: 29763850 PMCID: PMC6066472 DOI: 10.1016/j.ijscr.2018.04.028] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 04/20/2018] [Accepted: 04/26/2018] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION A Bochdalek hernia (BH) is a type of congenital diaphragmatic hernia. We herein describe an adult woman with a BH triggered by pregnancy and treated by laparoscopic surgery. PRESENTATION OF CASE A 26-year-old woman was referred to our hospital because of abdominal pain and dyspnea resulting from a left diaphragmatic hernia. She was diagnosed with a BH and underwent laparoscopic surgery. Her postoperative progress was satisfactory, and no recurrence was found at follow-up approximately 1 year later. DISCUSSION A recently published study reviewing detailed cases of laparoscopic and/or thoracoscopic repair of adult BH from 1999 to 2016 identified 30 cases. A laparoscopic approach for treatment of BH has recently attracted increasing interest. CONCLUSION Laparoscopic surgery can be safely performed on adults with BH without complications.
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Affiliation(s)
- Shotaro Matsudera
- First Department of Surgery, Dokkyo Medical University, Tochigi, Japan.
| | - Masanobu Nakajima
- First Department of Surgery, Dokkyo Medical University, Tochigi, Japan
| | | | - Hiroto Muroi
- First Department of Surgery, Dokkyo Medical University, Tochigi, Japan
| | - Maiko Kikuchi
- First Department of Surgery, Dokkyo Medical University, Tochigi, Japan
| | - Yosuke Shida
- First Department of Surgery, Dokkyo Medical University, Tochigi, Japan
| | - Keisuke Ihara
- First Department of Surgery, Dokkyo Medical University, Tochigi, Japan
| | - Satoru Yamaguchi
- First Department of Surgery, Dokkyo Medical University, Tochigi, Japan
| | - Kinro Sasaki
- First Department of Surgery, Dokkyo Medical University, Tochigi, Japan
| | - Takashi Tsuchioka
- First Department of Surgery, Dokkyo Medical University, Tochigi, Japan
| | - Hiroyuki Kato
- First Department of Surgery, Dokkyo Medical University, Tochigi, Japan
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