A comparison of clinical outcomes between endoscopic and open surgery to repair neonatal diaphragmatic hernia

Abstract

Objective: The objective of this study is to evaluate the clinical efficacies of open versus endoscopic surgery in the treatment of congenital diaphragmatic hernia (CDH) and investigate the feasibility and safety of endoscopic surgery as an alternative to open surgery in these cases. Patients and Methods: A retrospective analysis was performed from June 2002 to February 2014. A total of 59 cases were attempted. The neonates were divided into either an endoscopic or open surgery group. The pre-, intra- and post-operative data on the neonates were analysed, and the surgery-related complications, survival rates and recurrence rates were compared between the two groups. Results: Demographic characteristics were not significantly different between the two groups. Compared with open group, the hospital stay and post-operative mechanical ventilation time were significantly shorter, while surgery duration was significantly longer in the endoscopic surgery group. The recurrence rate was higher and the survival rate was lower in the endoscopic surgery group with no statistically significant and the recurrence rate has decreased over the past 5 years. Conclusions: We have demonstrated that the endoscopic surgery is safe and effective for repairing CDH. The endoscopic surgery is a minimally invasive procedure with fast post-operative recovery and a good cosmetic outcome.

Keywords

• Diaphragmatic hernia
• endoscopic surgery
• laparoscope
• neonate