Surgical conditions of the diaphragm:
Saved in:
| Format: | Book |
|---|---|
| Language: | English |
| Published: |
Philadelphia [u.a.]
Saunders
2009
|
| Series: | Thoracic surgery clinics
19,4 |
| Subjects: | |
| Online Access: | Inhaltsverzeichnis |
| Physical Description: | X S., S. 420 - 540 Ill. |
| ISBN: | 9781437713923 |
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Record in the Search Index
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| adam_text | Titel: Surgical conditions of the diaphragm
Autor: Darling, Gail
Jahr: 2009
Surgical Conditions of the Diaphragm
Contents
Preface
Gail Darling
IX
Surgical Conditions of the Diaphragm: Anatomy and Physiology 419
Masaki Anraku andYaron Shargall
The diaphragm (Greek: dia = in-between, phragma = fence) is a musculoaponeur-
otic structure that serves as the most important respiratory muscle and the separat-
ing structure between the abdominal and thoracic cavities. This article reviews the
anatomic components of the diaphragm, its pivotal role in respiration and in the
gastroesophageal mechanism, and the surgical implications of the anatomic
structuring.
Imaging the Diaphragm 431
Heidi C. Roberts
This article describes the normal and abnormal position, motion and morphology of
the diaphragm, on chest radiography and fluoroscopy, as well as on computed
tomography and magnetic resonance imaging.
Surgical Conditions of the Diaphragm: Posterior Diaphragmatic Hernias in Infants 451
Priscilla P.L. Chiu and Jacob C. Langer
Recent advances in the management of congenital diaphragmatic hernia patients
have resulted in a dramatic improvement in overall survival. The widespread use
of lung-preserving strategies, such as high-frequency oscillatory ventilation and ex-
tracorporeal membrane oxygenation, have provided ventilatory or circulatory sup-
port for underlying pulmonary hypoplasia while surgical management has been
deferred until medical stabilization has occurred. The increased survival, however,
has been accompanied by increased neurological, nutritional, and musculoskeletal
morbidities among long-term survivors. This article reviews the diagnosis and man-
agement strategies of congenital diaphragmatic hernia and the outcomes of con-
genital diaphragmatic hernia patients.
Foramen of Morgagni Hernia: Presentation and Treatment 463
Ahmed Nasr and Annie Fecteau
The article discusses the presentation and treatment of foramen of Morgagni hernia.
First, it describes the embryology of the diaphragm along with the incidence of as-
sociated anomalies. This is followed by the symptoms, diagnosis, and management.
Morgagni hernias are rare and most often asymptomatic; however, there is always
a concern about strangulated bowel. Diagnosis is usually by chest radiograph or
CT scan. The surgical approach may be either transabdominal or thoracic. Experi-
ence is increasing with minimally invasive approaches, which has a low recurrence
rate and an excellent prognosis.
Contents
Congenital Diaphragmatic Hernia in the Adult 469
Lana Schumacher and Sebastien Gilbert
Congenital diaphragmatic herniae (CDH) are uncommon in neonates and extremely
rare in adults. The clinical presentation of CDH in adults tends to be very different
from neonates. Many adults remain asymptomatic and CDH are diagnosed inciden-
tally. All CDH should be repaired. Minimally invasive surgical approaches are now
gaining popularity for the repair of CDH with excellent outcomes.
Paraesophageal Hernia: Clinical Presentation, Evaluation, and Management Controversies 473
Colin Schieman and Sean C. Grondin
Few topics within thoracic surgery are as controversial as the management of para-
esophageal hernias (PEH). In this article, the types of hiatal hernia are classified and
the clinical presentation and evaluation of patients with PEH are discussed. Contro-
versies in the management of PEH including the indications for surgery, the different
operative approaches, and the role of esophageal shortening are reviewed. Finally,
the evidence regarding the need for fundoplication or fixation of the stomach with
gastropexy or gastrostomy and the use of prosthetic material in performing the hiatal
closure are examined.
Acute Traumatic Diaphragmatic Injury 485
Wael C. Hannaand Lorenzo E. Ferri
Acute diaphragmatic hernia is a result of diaphragmatic injury that accompanies
severe blunt or penetrating thoracoabdominal trauma. The incidence, characteris-
tics, and diagnosis of acute diaphragmatic hernia are discussed. Acute traumatic
diaphragmatic injuries are treated by surgical reduction of the herniated organs, if
present, and closure of the diaphragmatic defect. The various treatment options
are discussed. Outcomes of acute diaphragmatic hernia repair are largely dictated
by the severity of concomitant injuries, with the Injury Severity Score being the
most widely recognized predictor of mortality.
Chronic Traumatic Diaphragmatic Hernia 491
Maurice Blitz and Brian E. Louie
Traumatic diaphragmatic hernia encompasses a spectrum of disease ranging from
acute to chronic. Chronic traumatic diaphragmatic hernia is uncommon and associ-
ated with significant morbidity and mortality. Multiplanar CT with coronal, sagittal,
and axial reconstructions is most effective in making this diagnosis. Once diag-
nosed, repair should be undertaken. Open transthoracic repair is preferred. Basic
hernia repair principles apply including the construction of a tension-free repair,
which may necessitate the use of prosthetics.
Acquired Paralysis of the Diaphragm 501
Michael Augustine Ko and Gail Elizabeth Darling
Acquired diaphragmatic paralysis is an uncommon cause of respiratory insufficiency
in adults. Symptoms of diaphragmatic paralysis range in severity from mild alter-
ations in exercise capacity to severe, life-threatening illness. For well-selected
patients, diaphragmatic plication is indicated for symptomatic relief. Plication may
be performed via standard thoracotomy or by video-assisted techniques.
Contents
Diaphragmatic Eventration 511
Shawn S. Groth and Rafael S. Andrade
Diaphragmatic eventration is defined as thinning of the diaphragm secondary to
a congenital deficiency in diaphragmatic muscle structure. Clinically, diaphragmatic
eventration can be impossible to differentiate from acquired paralysis. Diaphrag-
matic plication is indicated for symptomatic patients and leads to significant im-
provement in symptoms, quality of life, and pulmonary function tests.
Tumors of the Diaphragm 521
Min Peter Kim andWayne L. Hofstetter
Primary tumors of the diaphragm are very rare. Benign tumors of the diaphragm are
resected if symptomatic or if there is concern for malignancy. Malignant tumors are
either primary, metastatic, or the result of direct extension to the diaphragm from ad-
jacent malignancy. Malignant tumors are treated based on histology and response
to chemotherapy, with surgical resection performed when feasible.
Reconstructive Techniques After Diaphragm Resection 531
David J. Finley, Nadeem R. Abu-Rustum, Dennis S. Chi, and Raja Flores
Diaphragm resection requires complete reconstruction to avoid respiratory compro-
mise or herniation of abdominal contents into the chest. Primary reconstruction of
the diaphragm is often possible, even with a large defect, as long as the tissue
can come together without excessive tension. Larger defects or complete dia-
phragm resections necessitate reconstruction with synthetic material or autologous
tissue. These reconstructions can be accomplished safely and effectively by follow-
ing specific surgical tenets, and require an in-depth knowledge of the diaphragm s
anatomy, innervation, blood supply, and adjacent organs.
Index 537
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| physical | X S., S. 420 - 540 Ill. |
| publishDate | 2009 |
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| publisher | Saunders |
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| series | Thoracic surgery clinics |
| series2 | Thoracic surgery clinics |
| spelling | Surgical conditions of the diaphragm guest ed. Gail Darling Philadelphia [u.a.] Saunders 2009 X S., S. 420 - 540 Ill. txt rdacontent n rdamedia nc rdacarrier Thoracic surgery clinics 19,4 Chirurgie (DE-588)4009987-8 gnd rswk-swf Zwerchfell (DE-588)4079574-3 gnd rswk-swf Zwerchfell (DE-588)4079574-3 s Chirurgie (DE-588)4009987-8 s DE-604 Darling, Gail Sonstige (DE-588)140172947 oth Thoracic surgery clinics 19,4 (DE-604)BV019335438 19,4 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=018803755&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Surgical conditions of the diaphragm Thoracic surgery clinics Chirurgie (DE-588)4009987-8 gnd Zwerchfell (DE-588)4079574-3 gnd |
| subject_GND | (DE-588)4009987-8 (DE-588)4079574-3 |
| title | Surgical conditions of the diaphragm |
| title_auth | Surgical conditions of the diaphragm |
| title_exact_search | Surgical conditions of the diaphragm |
| title_full | Surgical conditions of the diaphragm guest ed. Gail Darling |
| title_fullStr | Surgical conditions of the diaphragm guest ed. Gail Darling |
| title_full_unstemmed | Surgical conditions of the diaphragm guest ed. Gail Darling |
| title_short | Surgical conditions of the diaphragm |
| title_sort | surgical conditions of the diaphragm |
| topic | Chirurgie (DE-588)4009987-8 gnd Zwerchfell (DE-588)4079574-3 gnd |
| topic_facet | Chirurgie Zwerchfell |
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