Standardized indications help performing thoracoscopic repair in neonates with congenital diaphragmatic hernia safely and successfully
Purpose: To analyze the clinical outcome of thoracoscopic repair of neonatal congenital diaphragmatic hernia(CDH)with standardized indications.Methods: Clinical data of 14 neonates with CDH underwent thoracoscopic repair from September 2013 to August 2014 were retrospectively analyzed.Selection criteria: weight beyond 2.0kg; liver in the abdomen; no intestinal obstruction; no severe cardiopulmonary anomalies; not required high frequency oscillatory ventilation or extracorporeal membrane oxygenation.Timing of surgery: mean arterial blood pressure normal for gestational age; preductal saturation levels of 85 to 95%on fractional inspired oxygen below 50%; lactate below 3 mmol/l; urine output more than 2 ml/kg/h.Fourteen cases in historical control group who underwent open repair with the same physiological status were reviewed for comparison.Results: Demographic features were similar between thoracoscopic repair(TR)group and open repair(OR)group.There were statistically significant differences in intraoperative mean PaCO2(48 ± 8 mmHg vs 39 ± 6 mmHg,P=.002)and mean pH(7.30±0.06 vs 7.39±0.06,P=.000)in arterial blood gas test but lactate(0.93±0.16 mmol/L vs 0.98±0.14 mmol/L,P=.387)did not differ between groups.Longer operation time was found in TR group(116±27 min vs 74±25 min,P=.000).There were no significant differences in mean ventilator time(113±51 hr vs 100±63 hr,P=.554).No recurrence was observed in groups within the first year of life follow-up.Conclusions: With selection criteria and timing,thoracoscopic repair of CDH in neonates can be performed safely and successfully.
Congenital diaphragmatic hernia thoracoscopy selection criteria timing of surgery complication
Guangzhou women and Children”s Medical Center
国内会议
沈阳
英文
1-13
2015-04-03（万方平台首次上网日期，不代表论文的发表时间）