Surgical treatment of congenital diaphragmatic hernia in a single institution
Abstract 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 trea...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-12-01
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| Series: | Journal of Cardiothoracic Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13019-022-02098-w |
| _version_ | 1797973489999675392 |
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| author | Hua Li Shengliang Zhao Chun Wu Zhengxia Pan Gang Wang Jiangtao Dai |
| author_facet | Hua Li Shengliang Zhao Chun Wu Zhengxia Pan Gang Wang Jiangtao Dai |
| author_sort | Hua Li |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-04-11T04:05:39Z |
| format | Article |
| id | doaj.art-d23751a87cbf4df495b6ff879f19b869 |
| institution | Directory Open Access Journal |
| issn | 1749-8090 |
| language | English |
| last_indexed | 2024-04-11T04:05:39Z |
| publishDate | 2022-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Cardiothoracic Surgery |
| spelling | doaj.art-d23751a87cbf4df495b6ff879f19b8692023-01-01T12:27:17ZengBMCJournal of Cardiothoracic Surgery1749-80902022-12-011711610.1186/s13019-022-02098-wSurgical treatment of congenital diaphragmatic hernia in a single institutionHua Li0Shengliang Zhao1Chun Wu2Zhengxia Pan3Gang Wang4Jiangtao Dai5Children’s Hospital of Chongqing Medical University; Department of Cardio-Thoracic Surgery; Ministry of Education Key Laboratory of Child Development and Disorders; National Clinical Research Center for Child Health and Disorders; China International Science and Technology Cooperation base of Child development and Critical Disorders;Chongqing Key laboratory of PediatricsChildren’s Hospital of Chongqing Medical University; Department of Cardio-Thoracic Surgery; Ministry of Education Key Laboratory of Child Development and Disorders; National Clinical Research Center for Child Health and Disorders; China International Science and Technology Cooperation base of Child development and Critical Disorders;Chongqing Key laboratory of PediatricsDepartment of Thoracic Surgery, Xinqiao Hospital, Army Medical University (Third Military Medical University)Department of Thoracic Surgery, Xinqiao Hospital, Army Medical University (Third Military Medical University)Department of Thoracic Surgery, Xinqiao Hospital, Army Medical University (Third Military Medical University)Department of Thoracic Surgery, Xinqiao Hospital, Army Medical University (Third Military Medical University)Abstract 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.https://doi.org/10.1186/s13019-022-02098-wCongenital diaphragmatic herniaMinimally invasive surgeryRisk stratificationThoracoscopicInfants |
| spellingShingle | Hua Li Shengliang Zhao Chun Wu Zhengxia Pan Gang Wang Jiangtao Dai Surgical treatment of congenital diaphragmatic hernia in a single institution Journal of Cardiothoracic Surgery Congenital diaphragmatic hernia Minimally invasive surgery Risk stratification Thoracoscopic Infants |
| title | Surgical treatment of congenital diaphragmatic hernia in a single institution |
| title_full | Surgical treatment of congenital diaphragmatic hernia in a single institution |
| title_fullStr | Surgical treatment of congenital diaphragmatic hernia in a single institution |
| title_full_unstemmed | Surgical treatment of congenital diaphragmatic hernia in a single institution |
| title_short | Surgical treatment of congenital diaphragmatic hernia in a single institution |
| title_sort | surgical treatment of congenital diaphragmatic hernia in a single institution |
| topic | Congenital diaphragmatic hernia Minimally invasive surgery Risk stratification Thoracoscopic Infants |
| url | https://doi.org/10.1186/s13019-022-02098-w |
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