Surg Today

. 2023 Oct 13.

 doi: 10.1007/s00595-023-02757-y. Online ahead of print. https://pubmed.ncbi.nlm.nih.gov/37831144/

Yousuke Gohda ¹, Kazuki Yokota ¹, Hiroo Uchida ², Chiyoe Shirota ¹, Takahisa Tainaka ¹, Wataru Sumida ¹, Satoshi Makita ¹, Aitaro Takimoto ¹, Shunya Takada ¹, Yoichi Nakagawa ¹, Takuya Maeda ¹, Yaohui Guo ¹, Akinari Hinoki ³

Safe thoracoscopic repair of recurrent congenital diaphragmatic hernia after initial open abdominal repair

Affiliations expand

• PMID: 37831144
• DOI: 10.1007/s00595-023-02757-y

Abstract

Purpose: The optimal surgical approach for recurrent congenital diaphragmatic hernia (CDH) remains controversial. We compared the surgical outcomes of a thoracoscopic approach versus an open abdominal approach for recurrent CDH after initial abdominal open repair.

Method: The subjects of this comparative study were patients who underwent open abdominal or thoracoscopic surgery for recurrent CDH following an initial open abdominal repair.

Results: Among 166 patients with Bochdalek-type CDH, 15 underwent reoperation for recurrent CDH following an open abdominal repair. Seven patients underwent open abdominal surgery (group O) and eight underwent thoracoscopic surgery (group T). The operative duration was similar for the two groups, with less blood loss (17.2 ml/kg vs. 1 ml/kg, P = 0.001) and fewer intraoperative complications in the T group (n = 6 vs. n = 0 cases, P = 0.001). There was no significant difference in the number of postoperative complications (n = 1 vs. n = 1, P = 1.0) or in the number of patients with a second CDH recurrence (n = 2 vs. n = 1, P = 0.569) between the two groups.

Conclusion: Thoracoscopic surgery is preferable to the open surgical approach for recurrent CDH following an initial abdominal open repair.

Keywords: Congenital diaphragmatic hernia; Recurrence; Thoracoscopic surgery.

© 2023. The Author(s) under exclusive licence to Springer Nature Singapore Pte Ltd.