caa a22 4500 475791193 CHVBK 20180406123711.0 cr unu---uuuuu 170329e20000301xx s 000 0 eng 10.1007/s004230050253 doi (NATIONALLICENCE)springer-10.1007/s004230050253 Laparoscopic management of traumatic ruptures of the diaphragm [Elektronische Daten] [C. Schneider, C. Tamme, H. Scheidbach, S. Delker-Wegener, F. Köckerling] Abstract : Introduction: As a result of the relatively high frequency of high-speed accidents, diaphragmatic rupture is a diagnosis that is increasingly being established. Not all of these, usually multi-traumatized, patients are diagnosed as having diaphragmatic rupture immediately following the traumatic event - rather, an appreciable number of these injuries are not detected until some time later - often after a considerable delay. Most of the cases involve rupture of the left diaphragm, with most defects occurring in the region of the central tendon. Methods: During the course of the second half of the year 1998, we operated on three patients with left diaphragmatic rupture. Two of these patients were treated immediately following traumatization, while the third case was a 10-year-old rupture originally misdiagnosed as a para-esophageal hernia. In all three cases, we were able to reduce the hernia and close the diaphragmatic defect laparoscopically. In the case of the two patients with a fresh rupture, the post-operative course was unremarkable, while in the patient with the missed rupture, a serous pleural effusion requiring drainage occurred on the left side. Conclusion: Overall, it would appear that in the case of an acute traumatic diaphragmatic rupture in particular, laparoscopic management, with its low level of traumatization and excellent access, offers a favorable alternative to conventional surgery. A point to be considered, however, is the fact that probably not every hospital will have the facilities for laparoscopic management available on a 24-h basis. In the case of long-standing ruptures, reduction of herniated bowel and treatment of the rupture will make considerable demands on the surgeon. Springer-Verlag Berlin Heidelberg, 2000 Key words Ruptures of the diaphragm nationallicence Laparoscopic treatment nationallicence Schneider C. Department of Surgery and Centre for Minimal Invasive Surgery, Academic Hospital Medical Highschool Hannover, Hanover Hospital, Roesebeckstr. 15 (Siloah), D-30449 Hannover, Germany e-mail: schneidersiloah@T-online.de Tel.: +49-511-9270 Fax: +49-511-2591, DE aut Tamme C. Department of Surgery and Centre for Minimal Invasive Surgery, Academic Hospital Medical Highschool Hannover, Hanover Hospital, Roesebeckstr. 15 (Siloah), D-30449 Hannover, Germany e-mail: schneidersiloah@T-online.de Tel.: +49-511-9270 Fax: +49-511-2591, DE aut Scheidbach H. Department of Surgery and Centre for Minimal Invasive Surgery, Academic Hospital Medical Highschool Hannover, Hanover Hospital, Roesebeckstr. 15 (Siloah), D-30449 Hannover, Germany e-mail: schneidersiloah@T-online.de Tel.: +49-511-9270 Fax: +49-511-2591, DE aut Delker-Wegener S. Department of Surgery and Centre for Minimal Invasive Surgery, Academic Hospital Medical Highschool Hannover, Hanover Hospital, Roesebeckstr. 15 (Siloah), D-30449 Hannover, Germany e-mail: schneidersiloah@T-online.de Tel.: +49-511-9270 Fax: +49-511-2591, DE aut Köckerling F. Department of Surgery and Centre for Minimal Invasive Surgery, Academic Hospital Medical Highschool Hannover, Hanover Hospital, Roesebeckstr. 15 (Siloah), D-30449 Hannover, Germany e-mail: schneidersiloah@T-online.de Tel.: +49-511-9270 Fax: +49-511-2591, DE aut https://doi.org/10.1007/s004230050253 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s004230050253 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Schneider C. Department of Surgery and Centre for Minimal Invasive Surgery, Academic Hospital Medical Highschool Hannover, Hanover Hospital, Roesebeckstr. 15 (Siloah), D-30449 Hannover, Germany e-mail: schneidersiloah@T-online.de Tel.: +49-511-9270 Fax: +49-511-2591, DE aut NATIONALLICENCE 700 1- Tamme C. Department of Surgery and Centre for Minimal Invasive Surgery, Academic Hospital Medical Highschool Hannover, Hanover Hospital, Roesebeckstr. 15 (Siloah), D-30449 Hannover, Germany e-mail: schneidersiloah@T-online.de Tel.: +49-511-9270 Fax: +49-511-2591, DE aut NATIONALLICENCE 700 1- Scheidbach H. Department of Surgery and Centre for Minimal Invasive Surgery, Academic Hospital Medical Highschool Hannover, Hanover Hospital, Roesebeckstr. 15 (Siloah), D-30449 Hannover, Germany e-mail: schneidersiloah@T-online.de Tel.: +49-511-9270 Fax: +49-511-2591, DE aut NATIONALLICENCE 700 1- Delker-Wegener S. Department of Surgery and Centre for Minimal Invasive Surgery, Academic Hospital Medical Highschool Hannover, Hanover Hospital, Roesebeckstr. 15 (Siloah), D-30449 Hannover, Germany e-mail: schneidersiloah@T-online.de Tel.: +49-511-9270 Fax: +49-511-2591, DE aut NATIONALLICENCE 700 1- Köckerling F. Department of Surgery and Centre for Minimal Invasive Surgery, Academic Hospital Medical Highschool Hannover, Hanover Hospital, Roesebeckstr. 15 (Siloah), D-30449 Hannover, Germany e-mail: schneidersiloah@T-online.de Tel.: +49-511-9270 Fax: +49-511-2591, DE aut Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer