Abstract
BackgroundThis study sought to investigate the clinical characteristics of congenital diaphragmatic eventration (CDE) and to compare the efficacies of thoracoscopy and traditional open surgery in infants with CDE.MethodsWe retrospectively analyzed the clinical data of 125 children with CDE (90 boys, 35 girls; median age: 12.2 months, range: 1 h-7 years; body weight: 1.99–28.5 kg, median body weight: 7.87 ± 4.40 kg) admitted to our hospital in the previous 10 years, and we statistically analyzed their clinical manifestations and surgical methods.ResultsA total of 108 children in this group underwent surgery, of whom 67 underwent open surgery and 41 underwent thoracoscopic diaphragmatic plication. A total of 107 patients recovered well postoperatively, except for 1 patient who died due to respiratory distress after surgery. After 1–9.5 years of follow-up, 107 patients had significantly improved preoperative symptoms. During follow-up, the location of the diaphragm was normal, and no paradoxical movement was observed. Eleven of the 17 children who did not undergo surgical treatment did not have a decrease in diaphragm position after 1–6 years of follow-up. The index data on the operation time, intraoperative blood loss, chest drainage time, 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).ConclusionsThe clinical symptoms of congenital diaphragmatic eventration vary in severity. Patients with severe symptoms should undergo surgery. Both thoracoscopic diaphragmatic plication and traditional open surgery can effectively treat congenital diaphragmatic eventration, but compared with open surgery, thoracoscopic diaphragmatic plication has the advantages of a short operation time, less trauma, and a rapid recovery. Thus, thoracoscopic diaphragmatic plication should be the first choice for children with congenital diaphragmatic eventration.
Highlights
This study sought to investigate the clinical characteristics of congenital diaphragmatic eventration (CDE) and to compare the efficacies of thoracoscopy and traditional open surgery in infants with CDE
CDE is considered to result from a congenital anomaly during the formation of the pleuroperitoneal membrane, as in Bochdalek diaphragmatic hernia, but that occurs in a later stage during embryonal growth [1]
The index data on the operation time, intraoperative blood loss, chest drainage time, postoperative mechanical ventilation time, postoperative hospital stay and postoperative Coronary care unit (CCU) admission time were better in the thoracoscopy group than in the open group
Summary
This study sought to investigate the clinical characteristics of congenital diaphragmatic eventration (CDE) and to compare the efficacies of thoracoscopy and traditional open surgery in infants with CDE. CDE is considered to result from a congenital anomaly during the formation of the pleuroperitoneal membrane, as in Bochdalek diaphragmatic hernia, but that occurs in a later stage during embryonal growth [1]. CDE is a rare pathology that occurs in 0.02 to 0.07/1000. Zhao et al BMC Surg (2020) 20:270 respiratory infections, low weight, and stunting. Severe cases may manifest as respiratory distress syndrome, seriously affecting the quality of life of children. Advancements in endoscopic surgery have allowed diaphragmatic eventration to be treated quickly and safely. We present our experience with different surgical procedures to treat 125 patients with CDE
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