Our Summary

This study looked at two different types of surgery for babies with congenital diaphragmatic hernia (CDH), a birth defect where there’s a hole in the diaphragm. The researchers looked at data from 41 patients who had either open surgery (laparotomy) or a less invasive surgery (thoracoscopic repair) between 2011 and 2019.

They found that babies who had the less invasive surgery were younger and spent less time on a ventilator after surgery. The less invasive surgery did take longer to perform, but these babies also started eating normally again more quickly. The length of the hospital stay was shorter for the less invasive surgery, but not by a significant amount.

The researchers also found that using nitrous oxide before surgery was linked to longer hospital stays and more time on a ventilator.

Overall, the less invasive surgery was safe and effective for treating CDH. The researchers recommend careful patient selection to get the best results.

FAQs

  1. What are the two types of surgeries for congenital diaphragmatic hernia (CDH) that were studied?
  2. How does the recovery process differ between the open surgery and the less invasive surgery for CDH?
  3. What was the effect of using nitrous oxide before CDH surgery?

Doctor’s Tip

One helpful tip a doctor might tell a patient about congenital diaphragmatic hernia repair is to discuss with your healthcare provider about the possibility of opting for a less invasive surgery, such as thoracoscopic repair, if it is suitable for your specific case. This type of surgery may result in a quicker recovery time and less time on a ventilator compared to open surgery. Additionally, avoiding the use of nitrous oxide before surgery may help reduce the length of hospital stay and time on a ventilator. It is important to carefully consider all options and discuss them with your healthcare team to determine the best course of treatment for you or your child.

Suitable For

Patients who are typically recommended for congenital diaphragmatic hernia repair include infants with a confirmed diagnosis of CDH, who are stable enough to undergo surgery, and who do not have any significant comorbidities that would increase the risk of surgery. It is important for the medical team to carefully assess each patient’s individual case and determine the best course of treatment based on their specific circumstances.

Timeline

Before CDH repair:

  • Patient is diagnosed with congenital diaphragmatic hernia through prenatal ultrasound or after birth
  • Patient may experience respiratory distress, feeding difficulties, and other symptoms
  • Patient undergoes imaging tests to confirm diagnosis and assess severity
  • Patient may require mechanical ventilation or other supportive measures to stabilize breathing before surgery

After CDH repair:

  • Patient undergoes either open surgery (laparotomy) or less invasive surgery (thoracoscopic repair)
  • Less invasive surgery may result in shorter time on ventilator, quicker return to normal feeding, and shorter hospital stay
  • Patient may still require monitoring and support for breathing and feeding after surgery
  • Patient may need follow-up care to monitor for any complications or long-term effects of CDH and surgery.

What to Ask Your Doctor

Some questions a patient should ask their doctor about congenital diaphragmatic hernia repair include:

  1. What are the different types of surgery options for congenital diaphragmatic hernia repair, and what are the pros and cons of each?
  2. How does the less invasive surgery (thoracoscopic repair) compare to open surgery (laparotomy) in terms of recovery time, length of hospital stay, and potential complications?
  3. What criteria are used to determine if a baby is a suitable candidate for less invasive surgery for congenital diaphragmatic hernia repair?
  4. Can you explain the potential risks and benefits of using nitrous oxide before surgery for congenital diaphragmatic hernia repair?
  5. What is the expected recovery process and timeline following congenital diaphragmatic hernia repair surgery?
  6. What follow-up care and monitoring will be needed after surgery for congenital diaphragmatic hernia repair?
  7. Are there any long-term effects or complications that may arise from congenital diaphragmatic hernia repair surgery?
  8. How often will follow-up appointments be needed after surgery, and what signs or symptoms should I watch for that may indicate a problem?
  9. Can you provide information on the success rates of congenital diaphragmatic hernia repair surgeries at your facility?
  10. Are there any specific dietary or activity restrictions that should be followed during the recovery period after congenital diaphragmatic hernia repair surgery?

Reference

Authors: Bawazir OA, Bawazir A. Journal: Afr J Paediatr Surg. 2021 Jan-Mar;18(1):18-23. doi: 10.4103/ajps.AJPS_76_20. PMID: 33595536