Evaluation of Congenital Diaphragmatic Hernia Repair with Thoracoscope in Neonates

Introduction: 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. Materials and Methods: 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. Results: a total number of 18 pa ents were included, of whom 9 underwent thoracoscopic repair and 9 underwent open repair. Mean age at the opera on 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 a t b irth i n T R g roup w as 3 7.2 weeks v s 37.89 weeks in o‎r group (P= 0.85).Birth weight in TR group was 2904.22 g vs. 2988.88g in o‎r group (P= 0.96). Delivery type i n T R g roup w as N VD i n 2 2.2% a nd C /S i n 7 7.8%;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 v s. O R n one ( P= 1), recurrence: TR 0vs. 1 o‎r (P= 0.3), Echo abnormal results: 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 a dmission: T R 1 8d v s. O R 25d (P= 0.04),commencement of enteral feeding: TR 8.7d vs. o‎r 5.7d (P= 0.78), complica ons: 1 in o‎r (P =0.3), survival: 1 death i n T R & 1 i n O R ( P= 1 ), death age: TR at 270d vs. o‎r 81d (P= 1). Conclusion: 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.