Long-term results of laparoscopic-assisted extracorporeal repair of Morgagni hernia in children and comparison of two different suturing techniques

Abstract

We aimed to review our long-term results of laparoscopic-assisted extracorporeal repair (LAER) of Morgagni Hernia (MH), and to compare the outcome of two extracorporeal suturing techniques. Medical records of patients who underwent LAER of MH between 2006–2019 were reviewed. Two groups were constituted according to the suturing technique; separate perpendicular suturing (SPS) through a stab incision (Group SPS) and multiple angled suturing (MAS) through a small skin incision (Group MAS), and surgical results of the groups were compared statistically. There were 19 (M/F:17/2) patients with a mean age at operation of 51.8 ± 48.09 months. The most common symptoms were pulmonary infections (n = 9) and respiratory distress (n = 3). Chest films were diagnostic in 94.7% patients. Mean diameter of the defects was 5 ± 1.8 cm; and colon was detected in the sac in 84.2%. All MH patients had sacs that were excised either totally (n = 15) or partially (n = 4). No patch repair was performed in our series. Mean duration of follow-up was 62.5 ± 42.9 months. There was one recurrence in a patient with connective tissue disorder in the Group SPS, 2 months after the initial surgery. There was one suture reaction 4 months after surgery in the Group MAS. There were no further complications. Surgical results and cosmesis were statistically insignificant between the two surgical technique groups. LAER of MH is efficient and should be the first choice of managment in children. Mesh repair may be considered for patients with connective tissue disorders. The two suturing techniques in LAER are comparable and do not affect the outcome.