Success of Right Thoracotomy versus Exploratory Laparotomy in Right sided Congenital Diaphragmatic Hernia in neonates

Abstract

Objective: Aim of current study is to determine the success of right thoracotomy versus exploratory laparotomy in right sided congenital diaphragmatic hernia in neonates. Study Design: Retrospective study Place and duration: The Children’s Hospital PIMS Islamabad. Jan 2021 to Dec 2021 Methods: Total 74 neonates had right sided congenital diaphragmatic hernia were included. All the neonates were admitted to hospital for surgery. Neonates were equally divided in two groups. Thirty seven patients in group I received thoracotomy and 37 patients in group II underwent for exploratory laparotomy. Post-surgery success rate among both groups were compared. Results: There were majority 41 (55.4%) males and 33 (44.6%) females. Mean age of the neonates was 13.7±4.19 days. Pre-operative tracheal intubation and cardiac malformation was found in 67 (90.4%) and 14 (18.9%) cases. Compared to thoracotomies, exploratory laparotomies were associated with shorter hospital stays, shorter durations of postoperative mechanical ventilation, and shorter times to optimum feeding. We found that recurrence rate in thoracotomy group was higher as compared to laparotomy group with p value <0.004. There were no any significant differences in postoperative complications between the two groups. In both groups, 3 (8.1%) and 1 (2.7%) patients were died. Conclusion: We concluded in this study that the exploratory laparotomy among patients of right sided congenital diaphragmatic hernia was effective and useful in terms of shorter hospital stay, short mechanical ventilation and less time to optimum feeding as compared to right thoracotomy. No any significant difference was found in terms of post-surgery complication among both groups. Keywords: Congenital Diaphragmatic Hernia (CDH), Exploratory laparotomy, Thoracotomy