Safety Of Thoracoscopic Repair Of Congenital Diaphragmatic Hernia

Abstract

Background: Congenital Diaphragmatic hernia (CDH) is a defect in the diaphragm leading to protrusion of contents of abdomen into the thoracic cavity affecting the development of the lungs, although advances in the management of CDH, the mortality and recurrence still high , this study to evaluate the safety of thoracoscopic repair of congenital diaphragmatic hernia.
Methods: this study is prospective study of 60 patients with unilateral Congenital diaphragmatic hernia In the period between August 2018 and April 2021, a sheet was filled for every patient which include preoperative data including full history ,examination and investigations , intraoperative data including operative time, and any intraoperative complications and post-operative data including mortality, recurrence and post-operative arterial blood gases.
Results: The infants age range from 4 days to 4 years, males were 36(60%) cases, The left side defect in 45(75%) cases while 15(25%) cases were right side, The mean of the operative time was 90.75 minutes, , no clinically significant difference in pH and paCO2 levels pre and post-operative, We converted to open (laparotomy) in 6(10%), The mortality was 12 (20%) cases, The recurrence was 3(5%) cases.
Conclusion: thoracoscopy is a safe approach to repair CDH in stable patients, no clinically significant difference in pH and paCO2 levels pre and post-operative, a thoracoscopic approach was associated with decreased mortality rate.