Thoracoscopic repiar of congenital diaphragmatic hernia: two centres' experience of 57 patients

Abstract

BACKGROUND/PURPOSE: With the advancement in laparoscopic techniques, thoracoscopic approach is gaining popularity in the treatment of congenital diaphragmatic hernia (CDH). In this study, we reviewed our early experience using this approach. METHODS: All patients who underwent thoracoscopic repair of CDH between 2009 and 2013 at two tertiary referral centres were identified. Medical records were retrospectively reviewed. Patients’ demographics, peri-operative outcomes, length of hospitalization and post-operative complications were analyzed. RESULTS: 57 patients were identified (43 males and 14 females). 5 patients had delayed presentation with operations done over 1 month old. The mean body weight was 2.88kg for patients operated in neonatal period. Left side was more prevalent (n=48). Mean operative time was 87.1 minutes (range 31-194 minutes). No conversion was required in any of the patients. All patients were routinely intubated and paralyzed in neonatal intensive care units for 3 days after operation. Average hospital stay was 14.6 days. There was no mortality in this series. There were 5 recurrences (8.8%), 3 of these were repaired openly and 2 thoracoscopically. No musculoskeletal deformity noted on follow-up. CONCLUSIONS: Thoracoscopic repair of CDH can be performed safely in specialized centres with good post-operative recovery, outcome and cosmesis.