Surgical treatment of congenital diaphragmatic hernia in a single institution

作者全名："Li, Hua; Zhao, Shengliang; Wu, Chun; Pan, Zhengxia; Wang, Gang; Dai, Jiangtao"

作者地址："[Li, Hua; Zhao, Shengliang] Chongqing Med Univ, Childrens Hosp, Chongqing 400037, Peoples R China; [Li, Hua; Zhao, Shengliang] Chongqing Med Univ, Childrens Hosp, Dept Cardiothorac Surg, Chongqing 400037, Peoples R China; [Li, Hua; Zhao, Shengliang] Natl Clin Res Ctr Child Hlth & Disorders, Chongqing 400037, Peoples R China; [Li, Hua; Zhao, Shengliang] China Int Sci & Technol Cooperat base Child Dev &, Chongqing 400037, Peoples R China; [Li, Hua; Zhao, Shengliang] Chongqing Key Lab Pediat, Chongqing 400037, Peoples R China; [Li, Hua; Zhao, Shengliang; Wu, Chun; Pan, Zhengxia; Wang, Gang; Dai, Jiangtao] Army Med Univ, Mil Med Univ 3, Xinqiao Hosp, Dept Thorac Surg, Chongqing 400037, Peoples R China; [Li, Hua; Zhao, Shengliang; Wu, Chun; Pan, Zhengxia; Wang, Gang; Dai, Jiangtao] Chongqing Med Univ, Dept Cardiothorac Surg, Childrens Hosp, 20, Jinyu Ave, Chongqing, Peoples R China"

通信作者："Dai, JT (通讯作者)，Chongqing Med Univ, Dept Cardiothorac Surg, Childrens Hosp, 20, Jinyu Ave, Chongqing, Peoples R China."

来源：JOURNAL OF CARDIOTHORACIC SURGERY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000906214000001

JCR分区：Q3

影响因子：1.6

年份：2022

卷号：17

期号：1

开始页：　

结束页：　

文献类型：Article

关键词：Congenital diaphragmatic hernia; Minimally invasive surgery; Risk stratification; Thoracoscopic; Infants

摘要："Background: This study aimed to evaluate the effectiveness of video-assisted thoracic surgery for the treatment of congenital diaphragmatic hernia (CDH) in a larger series compared with conventional open surgery. Additionally, we summarized the experience of thoracoscopic surgery in the treatment of CDH in infants. Methods: We retrospectively analysed the clinical data of 109 children with CDH who underwent surgical treatment at the Department of Cardiothoracic Surgery of Children's Hospital of Chongqing Medical University from January 2011 to January 2021. According to the surgical method, the children were divided into an open group (62 cases) and a thoracoscopy group (47 cases).Patients who underwent surgical correction had the diaphragmatic defect size graded (A-D) using a standardized system. We compared the operation time, intraoperative blood loss, postoperative mechanical ventilation time, postoperative hospital stay, postoperative CCU admission time and other surgical indicators as well as the recurrence rate, mortality rate and complication rate of the two groups of children. Results: The index data on the operation time, intraoperative blood loss, postoperative mechanical ventilation time, postoperative hospital stay and postoperative CCU admission time were better in the thoracoscopy group than in the open group. The difference between the two groups was statistically significant (P < 0.05). We compared the number of incision infections, lung infections, atelectasis, pleural effusion, and chylothorax between the two groups. There were more children in the open group than in the thoracoscopy group. The overall incidence of postoperative complications in the open group (51.61%) was higher than that in the thoracoscopy group (44.68%).The recurrence rate of the thoracoscopy group (8.51%) was higher than that of the open group (3.23%). In the open group, 7 patients died of respiratory distress after surgery, and no patients died in the thoracoscopy group. Conclusions: Thoracoscopic surgery and open surgery can effectively treat CDH. Compared with conventional open surgery, thoracoscopy has the advantages of shorter operation time, less trauma, faster recovery and fewer complications. We believe that thoracoscopic surgery for type A/B diaphragmatic defect has certain advantages, but there is a risk of recurrence."

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