Transthoracic approach in surgical management of Morgagni hernia

Objective: Morgagni hernia is an uncommon type of diaphragmatic hernias, Nu merous approaches have been described and, particularly the significance of laparatomy has been emphasized as an operative technique. We present our e xperience on patients with Morgagni hernia operated on via transthoracic ap proach in our department. Materials and methods: Between January 1986 and M arch 2000, 16 patients with Morgagni hernia were operated in our department . Their ages ranged from 16 to 68 years (mean 51.5). Five (31.25%) patients were male, and 11 (68.75%) patients were female. Chest roentgenograms, tho rax CT, barium enema roentgenographic studies were used as diagnostic utili ties. Right posterolateral thoracotomy was performed in all patients. Resul ts: Hernia sac was present in all cases. Exploration revealed omentum in he rnia sac in eight patients (50%), colon and omentum in seven patients (44%) , only colon in one patient (%6). Postoperative course was uneventful. The mean follow-up was 5.7 years. There was no recurrence or symptoms related t o the operation. Conclusions: We advocate transthoracic approach for surgic al exposure as it provides wide exposure and easy repair of the hernia sac in Morgagni hernia. (C) 2001 Published by Elsevier Science B.V.