Shifting From Laparotomy to Thoracoscopic Repair of Congenital Diaphragmatic Hernia in Neonates: Early Experience

Abstract

Except in patients receiving ECMO treatment, thoracoscopic repair is useful and feasible regardless of defect size or need for patching. Operation time is longer, but cosmetic appearance is better and intestinal obstruction uppers to be less frequent. However, intensive training is needed to prevent the recurrence.

Thoracoscopic repair of congenital diaphragmatic hernia: two centres’ experience with 60 patients

“…To our surprise, no conversion to open thoracotomy or laparotomy was required. The mean operative time in our series was 88.5 min, which was similar to that reported by Liem et al [14] (75 min), Nam et al [22] (118 min) and Tanaka et al [23] (194 min). In fact the operative time was the same if not faster than that of the open approach group in these comparative studies (88.3 and 161 min, Nam et al [22] and Tanaka et al [23], respectively).…”

“…The mean operative time in our series was 88.5 min, which was similar to that reported by Liem et al [14] (75 min), Nam et al [22] (118 min) and Tanaka et al [23] (194 min). In fact the operative time was the same if not faster than that of the open approach group in these comparative studies (88.3 and 161 min, Nam et al [22] and Tanaka et al [23], respectively). Chest tube drainage has been advocated by Liem et al [14] in one of the largest published series to prevent pleural effusion, but we only encountered two such complications (3.3 %) which later subsided spontaneously.…”

Surgical approaches for neonatal congenital diaphragmatic hernia: a systematic review and meta-analysis

“…There was very serious risk of bias due to inappropriate patient selection, unequal follow-up durations, and the absence of controlling for confounding. Particularly, selection bias cannot to be ignored; patients who underwent ES were selected by their surgeons or according to facility criteria in six of the studies [16][17][18][19][20][21]. Therefore, the ES groups potentially included milder cases, as compared with the OS groups.…”

“…The eight observational studies were included in a quantitative synthesis [14][15][16][17][18][19][20][21]. The eight studies included a total of 4698 patients, of whom 288 belonged to ES groups and 4410 belonged to OS groups.…”

“…After screening the remaining 38 studies based on their full texts, 14 studies were included in the qualitative synthesis [8][9][10][11][12][13][14][15][16][17][18][19][20][21]. Furthermore, eight observational studies [14][15][16][17][18][19][20][21] published between 2009 and 2013 were included in the quantitative synthesis ( Fig.…”