PS-295 Clinical Experience In Application Of Thoracoscopy In Treatment Of Congenital Diaphragmatic Hernia In Newborns

Abstract

Background and aims The treatment of newborns with congenital diaphragmatic hernia (CDH) is still actual problem. Changing management tactics has led to an improvement in results last decade. The mini-invasive surgical procedure was developed and introduced in clinic adding new abilities. The goal is to determine the effectiveness of thoracoscopy in treatment of CDH in newborns. Methods The retrospective analysis of treatment of 127 infants with CDH during the period from 1993 to 2013 in Paediatric Surgery Centre of Minsk, Belarus was conducted. From 1993 to 2006, the newborns were operated on 1–2 day admission. Traditional methodslaparotomy and thoracotomy applied in 59 of 65 children in this group, 16 patients died. Post operativelethality was 27.1%, the overall mortality rate30.7%. Postoperative complications have demanded 18 (30.5%) reoperations in 13 patients, including 4 hernias relapse. From January 2007 operation are produced only in children with stable condition on the 6–8 day of life. The main method from December 2009 is thoracoscopic plastic. The 62 children have been treated. Operations were performed in 54 children: 16 children by traditional methods and 38 completed mini-invasive intervention. Results Four patients (7.4%) died postoperatively and overall mortality amounted to 12.9%. Reoperations took place in 10 patients (18.6%), 5 children have recurrent hernia after thoracoscopic plastic. One child relapse marked twice in 6 months. All children repeatedly operated with thoracoscopy, in four cases patches were applied. No complications were revealed postoperatively. Conclusion Thoracoscopy for the treatment of CDH is effective method.