We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Comprehensive meta-analysis of surgical procedure for congenital diaphragmatic hernia: thoracoscopic versus open repair.
- Authors
Shibuya, Soichi; Paraboschi, Irene; Giuliani, Stefano; Tsukui, Takafumi; Matei, Andreea; Olivos, Maricarmen; Inoue, Mikihiro; Clarke, Simon A.; Yamataka, Atsuyuki; Zani, Augusto; Eaton, Simon; De Coppi, Paolo
- Abstract
Purpose: Previous studies have shown a higher recurrence rate and longer operative times for thoracoscopic repair (TR) of congenital diaphragmatic hernia (CDH) compared to open repair (OR). An updated meta-analysis was conducted to re-evaluate the surgical outcomes of TR. Methods: A comprehensive literature search comparing TR and OR in neonates was performed in accordance with the PRISMA statement (PROSPERO: CRD42020166588). Results: Fourteen studies were selected for quantitative analysis, including a total of 709 patients (TR: 308 cases, OR: 401 cases). The recurrence rate was higher [Odds ratio: 4.03, 95% CI (2.21, 7.36), p < 0.001] and operative times (minutes) were longer [Mean Difference (MD): 43.96, 95% CI (24.70, 63.22), p < 0.001] for TR compared to OR. A significant reduction in the occurrence of postoperative bowel obstruction was observed in TR (5.0%) compared to OR (14.8%) [Odds ratio: 0.42, 95% CI (0.20, 0.89), p = 0.02]. Conclusions: TR remains associated with higher recurrence rates and longer operative times. However, the reduced risk of postoperative bowel obstruction suggests potential long-term benefits. This study emphasizes the importance of meticulous patient selection for TR to mitigate detrimental effects on patients with severe disease.
- Subjects
DIAPHRAGMATIC hernia; NEONATAL surgery; MINIMALLY invasive procedures; BOWEL obstructions; PATIENT selection
- Publication
Pediatric Surgery International, 2024, Vol 40, Issue 1, p1
- ISSN
0179-0358
- Publication type
Article
- DOI
10.1007/s00383-024-05760-7