Introduction:
Morgagni hernia (MH) is a rare congenital diaphragmatic defect, accounting for less than 5% of all congenital diaphragmatic hernias. It occurs through the retrosternal (Larrey's) space and may remain asymptomatic until late childhood. While various surgical approaches exist, laparoscopic transabdominal repair has emerged as a preferred minimally invasive option.
Objectives:
To evaluate the clinical characteristics, operative outcomes, and predictors of postoperative recovery in children undergoing surgical repair for Morgagni hernia over an 18-year period.
Results:
A total of 63 pediatric patients underwent MH repair. The mean age at presentation was 22.2 ± 28.7 months, with a male predominance (79.4%). Most patients were full-term (68%) and presented with recurrent respiratory infections (85.7%). Laparoscopic repair was performed in 76.2% of cases. The colon was the most frequent herniated content (54%), and the mean operative time and hospital stay were 120.9 ± 40.5 minutes and 6.1 ± 4.9 days, respectively. Only one recurrence (1.5%) was noted.
Subgroup analysis showed that Down syndrome (28.6%) was significantly associated with cardiac anomalies (p = 0.003), but did not significantly affect other perioperative variables. Similar findings were observed in the cardiac vs non-cardiac comparison.
Multivariate linear regression revealed that higher weight at surgery was significantly associated with shorter operative duration (p = 0.024). Age and weight at surgery showed trends toward influencing hospital stay, though not statistically significant (p = 0.066 and 0.067). Neither Down syndrome nor cardiac anomalies significantly impacted surgical or recovery outcomes.
Conclusion:
Laparoscopic repair is a safe and effective approach for Morgagni hernia in children, with low recurrence and favorable outcomes. Patient weight, rather than syndromic or cardiac status, appears to be a more relevant predictor of operative and recovery parameters.
Keywords: Children, Laparoscopy, Morgagni Hernia, Pediatric
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