Evaluation of Congenital Diaphragmatic Hernia Repair with Thoracoscope in Neonates

congenital diaphragmatic hernia (CDH) is one of the most common congenital anomalies with significant morbidity and mortality. The most common form of CDH is Bochdaleck type of the anomaly, with the defect located in poster lateral part of the diaphragm. The aim of this retrospective study was to compare the outcome of open repair (OR) with thoracoscopic repair (TR) for Bochdaleck CDH at Mofid Children Hospital.

neonates with Bochdaleck CDH at Mofid Children Hospital from 2015 to 2018 were studied. After meeting the criteria, the information during and after surgery was recorded in the questionnaire. We compared the data with independent T- test and Chi-square.

a total number of 18 patients were included, of whom 9 underwent thoracoscopic repair and 9 underwent open repair. Mean age at the operation was 5.3 days in TR group vs. 3.89days in OR group(P= 0.9). In TRgroup 37.5% of the patients were female and 62.5% male, versus OR group with 22.2% female and 77.8% male (P= 0.62).Gestational age at birth in TR group was 37.2 weeks vs 37.89 weeks in OR group (P= 0.85).Birth weight in TR group was 2904.22 g vs. 2988.88gin OR group (P= 0.96). Delivery type in TR group was NVD in 22.2% and C/S in 77.8%;vs. 33.3% NVD and 66.7% C/S in OR group (P = 1). In TR group none had prenatal diagnosis, while in OR group 11.1% had and 88.9% didn’t have prenatal diagnosis (P= 1). Entrance status to Mofid Children Hospital: all of them were nonintubated, with no family history of CDH. CPR Hx: TR one vs. OR none (P= 1), recurrence: TR 0vs. 1 OR (P= 0.3), Echo abnormal

TR 44.4 % vs. OR 66.7 (P=0.63), brain abnormal US: TR 0 vs. OR 1 (P= 0.38), skeletal anomaly: 1in TR (P= 1), post-op admission: TR 18d vs. OR 25d (P= 0.04),commencement of enteral feeding: TR 8.7d vs. OR 5.7d (P= 0.78), complications: 1 in OR (P =0.3), survival: 1 death in TR & 1 in OR (P= 1),death age: TR at 270d vs. OR 81d (P= 1).

thoracoscopic repair appears to be as effective as open repair for treating cardiopulmonary stable patients. Thoracoscopic repair is in some way much better than open repair such as wound cosmetic and hospital stay.