Thoracoscopic Versus Open Congenital Diaphragmatic Hernia Repair: Single Tertiary Center Review

Tyson, Anna F.; Sola, Richard; Arnold, Michael R.; Cosper, Graham H.; Schulman, Andrew

doi:10.1089/lap.2017.0298

Cited by 41 publications

(32 citation statements)

References 19 publications

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“…Length of hospital stay was reported in 11 NRSs comparing 3,499 patients. [14][15][16][17][18][19][20][21][22][23][24] Hospital stay was shorter in patients undergoing VATS diaphragmatic hernia repair in five NRSs (45.5%) including 3,287 patients (93.3%). 14,15,[19][20][21] Postoperative ventilation time was compared in 11 NRSs reporting on 562 patients.…”

Section: Advantages Of Vatsmentioning

confidence: 99%

“…[14][15][16][17][18][19][20][21][22][23][24] Hospital stay was shorter in patients undergoing VATS diaphragmatic hernia repair in five NRSs (45.5%) including 3,287 patients (93.3%). 14,15,[19][20][21] Postoperative ventilation time was compared in 11 NRSs reporting on 562 patients. [14][15][16][17][18][19][20][23][24][25][26] Shorter postoperative ventilation after VATS repair was found in seven studies (63.6%) including 427 patients (45.1%).…”

Section: Advantages Of Vatsmentioning

confidence: 99%

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Video-Assisted Thoracoscopic or Conventional Thoracic Surgery in Infants and Children: Current Evidence

et al. 2020

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Introduction The pros and cons of video-assisted thoracoscopic versus conventional thoracic surgery in infants and children are still under debate. We assessed reported advantages and disadvantages of video-assisted thoracoscopy in pediatric surgical procedures, as well as the evidence level of the available data. Materials and Methods A systematic literature search was performed to identify manuscripts comparing video-assisted thoracoscopic and the respective conventional thoracic approach in classic operative indications of pediatric surgery. Outcome parameters were analyzed and graded for level of evidence (according to the Oxford Centre of Evidence-Based Medicine). Results A total of 48 comparative studies reporting on 12,709 patients, 11 meta-analyses, and one pilot randomized controlled trial including 20 patients were identified. More than 15 different types of advantages for video-assisted thoracoscopic surgery were described, mostly with a level of evidence 3b or 3a. Most frequently video-assisted thoracoscopic surgery was associated with shorter hospital stay, shorter postoperative ventilation, and shorter time to chest drain removal. Mortality rate and severe complications did not differ between thoracoscopic and conventional thoracic pediatric surgery, except for congenital diaphragmatic hernia repair with a lower mortality and higher recurrence rate after thoracoscopic repair. The most frequently reported disadvantage for video-assisted thoracoscopic surgery was longer operative time. Conclusion The available data point toward improved recovery in pediatric video-assisted thoracoscopic surgery despite longer operative times. Further randomized controlled trials are needed to justify the widespread use of video assisted thoracoscopy in pediatric surgery.

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Section: Advantages Of Vatsmentioning

confidence: 99%

Section: Advantages Of Vatsmentioning

confidence: 99%

Video-Assisted Thoracoscopic or Conventional Thoracic Surgery in Infants and Children: Current Evidence

et al. 2020

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“…It had been debated in earlier studies that recurrences are higher (ranging from 5-40%) following thoracoscopic repair than open repair [5,15,17,18]. In 2017 Tyson., et al [19] in his study reported zero recurrence rate in thoracoscopic cohort and Liem., et al reported 3.6% recurrence rate [7]. In our study we observed only 2.7% recurrence rate.…”

Section: Reason Is To Perform Intracorporeal Suturing Easily In Everymentioning

confidence: 88%

Thoracoscopic Repair of Congenital Diaphragmatic Hernia, First Ever Study from Pakistan

Brohi¹,

Mengal²

2019

Act Scie Paedia

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To analyze indications and to present demographic data, details of surgical technique and outcomes of thoracoscopic repair for congenital diaphragmatic hernia. Methodology: This is retrospectively study conducted at one of the medical university of Pakistan and we reviewed medical records of 37 patients with CDH who underwent thoracoscopic repair by the same surgical team from March 2013 to June 2017. The operations were performed using three trocars one 5mm for camera below scapula at 5th ICS and two 3mm working ports one space below camera port, one at posterior axillary line and other 3mm working port between tip of scapula and vertebral line. Pleural insufflation with carbon dioxide was maintained at a pressure of 4-6 mm Hg. The hernia defect was repaired using nonabsorbable-interrupted intracorporeal suturing with 2/0 silk or 2/0 ethibond. A prosthetic proline mesh was used in 4 patients when primary closure of the hernia defect was not feasible. Results: There were 37 patients, including 13 boys and 24 girls. 12 patients were newborns, 17 patients were infants 8 above infantile age. The hernia was located on the left side in 31 (83.78%) patients and on right side in 6 patients (16.21%). The operative time for thoracoscopic approach was between 80 to 150 minutes. 15 patients required mechanical ventilator support. Conversion was done in one patient who was not maintaining saturation. Follow-up was obtained in 29 (78.37%) patients ranging from 1 to 6 months. 1 patient had recurrence that required open redo repair. Conclusions: Thoracoscopic repair is feasible and safe for neonates and infants with CDH. Our initial results are better because majority of patients were not neonates and others presented a little later in infancy and in stable condition.

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“…Не подлежит сомнению, что торакоскопия избавляет пациентов от образования вентральных грыж и внутрибрюшных адгезий. A. Tyson [10] и соавт. сообщают о 4 больных с послеоперационными грыжами брюшной стенки и 5 больных, у которых после открытых операций развился спаечный илеус.…”

Section: Discussionunclassified

“…До сих пор не ясно, может ли эта технология использоваться с оптимальными результатами в госпиталях, в которых проходят лечение незначительное количество пациентов. В настоящее время имеется несколько отчетов о лечении детей с ВДГ с использованием минимально инвазивных технологий [2][3][4][5][6][7][8][9][10]. Известно несколько РКИ, в которых в основном обсуждались вопросы изучения изменения уровня острофазовых пептидов [11] и газового состава крови [12] в ходе реконструкции диафрагмальных дефектов.…”

Section: Original Articlesunclassified

Multicentral study of thoracoscopic treatment of congenital diaphragmatic hernia

Kozlov¹,

Kovalkov²,

Tchubko³

et al. 2018

Endosk. khir.

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4 МАУЗ детская городская клиническая больница №5, Кемерово, Россия; КГБУЗ «Красноярский краевой клинический центр охраны материнства и детства», Красноярск, Россия В работе представлен 15-летний опыт (2002-2017) лечения 197 больных с врожденной диафрагмальной грыжей из трех детских госпиталей, расположенных в Сибирском федеральном округе. Материал и методы. Больные были распределены в две группы: 1-я группа-90 больных, которым пластика купола диафрагмы выполнена с помощью торакоскопии; 2-я группа-107 пациентов, которым устранение диафрагмального дефекта произведено с использованием открытых методик-торакотомии либо лапаротомии. В отношении пациентов применены единые технологические приемы выполнения торакоскопической пластики купола диафрагмы и рекомендации послеоперационного ведения таких больных, исходящие и контролируемые наблюдателями из Ивано-Матренинской детской клинической больницы, Иркутск (экспертный госпиталь). Результаты. Сравниваемые группы имели одинаковые демографические параметры. Были обнаружены значимые различия в длительности между торакоскопическими и открытыми операциями (64,18 мин против 73,92 мин; p<0,5). Продолжительность пребывания в отделении неонатальной интенсивной терапии и госпитале была статистически меньше в 1-й группе (8,82 против 12,5 дня; 19,27 против 26,46 дня соответственно; p<0,05). Синтетические материалы для реконструкции дефекта диафрагмы использованы у 21 (23,33%) пациента 1-й группы и у 14 (13,08%)-2-й группы. Рецидив диафрагмальной грыжи в нашем исследовании обнаруживался у 10 (11,11%) пациентов 1-й группы и 20 (18,69%)-2-й группы. Послеоперационный хилоторакс регистрировался у 23 (25,56%) пациентов 1-й группы и 24 (22,42%)-2-й группы. Летальность в 1-й группе была меньше, чем во 2-й группе (8,89% против 17,76%). Фундопликация Ниссена была выполнена у 14 (15,56%) пациентов 1-й группы и 10 (9,35%)-2-й группы. Заключение. Торакоскопическая реконструкция ВДГ может быть безопасно выполнена опытными эндоскопическими хирургами из разных центров, объединенных одной идеологией выполнения эндохирургических операций.

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Thoracoscopic Versus Open Congenital Diaphragmatic Hernia Repair: Single Tertiary Center Review

Cited by 41 publications

References 19 publications

Video-Assisted Thoracoscopic or Conventional Thoracic Surgery in Infants and Children: Current Evidence

Video-Assisted Thoracoscopic or Conventional Thoracic Surgery in Infants and Children: Current Evidence

Thoracoscopic Repair of Congenital Diaphragmatic Hernia, First Ever Study from Pakistan

Multicentral study of thoracoscopic treatment of congenital diaphragmatic hernia

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