Surg Today
. 2022 Nov 4.
doi: 10.1007/s00595-022-02609-1. Online ahead of print. https://pubmed.ncbi.nlm.nih.gov/36333435/
Tension-free thoracoscopic repair of congenital diaphragmatic hernia combined with a percutaneous extracorporeal closure technique: how to do it
Koichi Deguchi 1, Miho Watanabe 1, Tomohisa Yoneyama 1, Kazunori Masahata 1, Motonari Nomura 1, Ryuta Saka 1, Hiroaki Yamanaka 1, Masafumi Kamiyama 1, Takehisa Ueno 1, Yuko Tazuke 1, Hiroomi Okuyama 2
Affiliations expand
- PMID: 36333435
- DOI: 10.1007/s00595-022-02609-1
Abstract
Purpose: Thoracoscopic repair (TR) of congenital diaphragmatic hernia (CDH) is associated with a higher recurrence rate than the conventional open method. We evaluated the effectiveness of our strategy for quality improvement, named “tension-free TR of CDH”.
Methods: The subjects of this retrospective analysis were 11 consecutive patients with CDH who underwent TR at our hospital between 2017 and 2021. Tension-free TR of CDH included the proactive use of an oversized patch for dome-shaped reconstruction and gapless suturing. We developed a percutaneous extracorporeal closure technique for secure suturing using a commercially available needle.
Results: Patch repair was performed in 8 (73%) patients and none required conversion to open surgery because of technical difficulties. Recurrence developed in one patient (9%), who underwent successful reoperation via TR. All patients had an uneventful postoperative course.
Conclusion: Tension-free TR combined with extracorporeal closure could reduce the difficulty of suturing and the risk of recurrence of CDH.
Keywords: Congenital diaphragmatic hernia; Recurrence; Thoracoscopic surgery.
© 2022. The Author(s) under exclusive licence to Springer Nature Singapore Pte Ltd.
