PDF(Pubmed)
Abstract：
UNASSIGNED: Diaphragmatic hernias with strangulated contents are a surgical challenge. Thoracoabdominal incisions are commonly used for a variety of thoracic and vascular cases, although rarely used for diaphragmatic hernias, which are typically repaired with laparotomy, thoracotomy, or minimally invasive approaches.
UNASSIGNED: We present the unique case of a 60-year-old, critically ill unstable patient with severe heart failure with a reduced ejection fraction (15-25%) and severe valve disease presenting with a left-sided diaphragmatic hernia containing strangulated small intestine and requiring urgent surgical exploration. This was safely and efficiently repaired via a thoracoabdominal approach at the index surgery, with intestines left in discontinuity and placement of temporary chest and abdominal closure. At the second planned operation, good continuity was successfully restored.
UNASSIGNED: The patient had early extubation, gradual diet advancement with full recovery, and discharge home on postoperative day 17.
UNASSIGNED: A thoracoabdominal incision can safely be used in large strangulated diaphragmatic hernias, including in critically unstable patients. This approach provides rapid access to both the chest and abdomen with excellent, speedy, and safe exposure, which can save a life in extreme conditions.
UNASSIGNED: We present the unique case of a 60-year-old, critically ill unstable patient with severe heart failure with a reduced ejection fraction (15-25%) and severe valve disease presenting with a left-sided diaphragmatic hernia containing strangulated small intestine and requiring urgent surgical exploration. This was safely and efficiently repaired via a thoracoabdominal approach at the index surgery, with intestines left in discontinuity and placement of temporary chest and abdominal closure. At the second planned operation, good continuity was successfully restored.
UNASSIGNED: The patient had early extubation, gradual diet advancement with full recovery, and discharge home on postoperative day 17.
UNASSIGNED: A thoracoabdominal incision can safely be used in large strangulated diaphragmatic hernias, including in critically unstable patients. This approach provides rapid access to both the chest and abdomen with excellent, speedy, and safe exposure, which can save a life in extreme conditions.
摘要：
未经证实：牵张内容物的膈疝是一项手术挑战。胸腹切口通常用于各种胸部和血管病例，虽然很少用于膈疝,通常用剖腹手术修复，开胸手术,或微创方法。
未经评估：我们提出了一个60岁的独特案例，重症不稳定患者，伴有严重心力衰竭，射血分数降低（15-25％）和严重瓣膜疾病，表现为左侧膈疝，包含绞窄的小肠，需要紧急手术探查。在索引手术中通过胸腹入路安全有效地修复了这一点，肠子不连续，暂时关闭胸部和腹部。在第二次计划行动中，成功恢复了良好的连续性。
未经证实：患者早期拔管，逐步推进饮食与完全康复，术后第17天出院回家。
UNASSIGNED：胸腹切口可以安全地用于大型绞窄性膈疝，包括严重不稳定的患者。这种方法提供了快速进入胸部和腹部，speedy,和安全暴露，可以在极端条件下拯救生命。
未经评估：我们提出了一个60岁的独特案例，重症不稳定患者，伴有严重心力衰竭，射血分数降低（15-25％）和严重瓣膜疾病，表现为左侧膈疝，包含绞窄的小肠，需要紧急手术探查。在索引手术中通过胸腹入路安全有效地修复了这一点，肠子不连续，暂时关闭胸部和腹部。在第二次计划行动中，成功恢复了良好的连续性。
未经证实：患者早期拔管，逐步推进饮食与完全康复，术后第17天出院回家。
UNASSIGNED：胸腹切口可以安全地用于大型绞窄性膈疝，包括严重不稳定的患者。这种方法提供了快速进入胸部和腹部，speedy,和安全暴露，可以在极端条件下拯救生命。
