Safe Thoracoscopic Repair of Recurrent Congenital Diaphragmatic Hernia After Initial Open Abdominal Repair

Overview

Journal Surg Today

Specialty General Surgery

Date 2023 Oct 13

PMID 37831144

Authors

Yousuke Gohda

Kazuki Yokota

Hiroo Uchida

Chiyoe Shirota

Takahisa Tainaka

Wataru Sumida

Satoshi Makita

Aitaro Takimoto

Shunya Takada

Yoichi Nakagawa

Takuya Maeda

Yaohui Guo

Akinari Hinoki

Affiliations

Soon will be listed here.

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.

Citing Articles

Minimally Invasive Approach Versus Traditional Approach for Treating Congenital Diaphragmatic Hernia: A Systematic Review and Meta-Analysis.

Aljuhani A, Alsumaili A, Alyaseen E, Daak L, Esmail A, Alzohari J Cureus. 2025; 17(1):e77596.

PMID: 39963632 PMC: 11830498. DOI: 10.7759/cureus.77596.

Marginal Indication for Thoracoscopic Surgery for Neonatal Bochdalek Hernia: "Anchor-Shaped Closure" Technique for the Patient's Own Residual Diaphragm Using a Loop Needle Device.

Kedoin C, Sugita K, Harumatsu T, Tabata Y, Iwamoto Y, Ogata M Asian J Endosc Surg. 2025; 18(1):e70032.

PMID: 39956160 PMC: 11830491. DOI: 10.1111/ases.70032.

Surgical management of the diaphragmatic defect in congenital diaphragmatic hernia: a contemporary review.

Jank M, Boettcher M, Keijzer R World J Pediatr Surg. 2024; 7(3):e000747.

PMID: 39183804 PMC: 11340723. DOI: 10.1136/wjps-2023-000747.

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