Our Summary

This research paper looks at how effective a particular type of surgery, called thoracoscopic repair, is for treating newborn babies with a condition known as congenital diaphragmatic hernia. Congenital diaphragmatic hernia is a birth defect where there’s a hole in the diaphragm, the muscle that helps us breathe. This hole can allow organs from the abdomen to move into the chest, which can cause serious problems.

The study looked at 47 newborns who were treated with this surgery between 2012 and 2017. It analyzed various factors like the baby’s age when admitted, how far along the pregnancy was when they were born, their birth weight, when the hernia was diagnosed, where the hernia was located, the symptoms presented, when the surgery was performed, the type of surgery, how long the surgery took, and how long the baby needed help from a ventilator after the surgery.

Out of the 47 babies, 42 had the hernia on the left side and 5 on the right. 13 were diagnosed before they were born. Most of the surgeries (45 out of 47) were successfully done through thoracoscopic repair, but 2 had to be switched to a different type of surgery. On average, the surgery took about an hour, there was very little blood loss, and the babies needed a ventilator for about 4 days after the surgery. Unfortunately, 2 babies died and 3 others had to stop treatment, but the rest (89.4%) were cured.

The study concludes that thoracoscopic repair is a very effective treatment for congenital diaphragmatic hernia in newborns and should be the first choice of treatment.

FAQs

  1. What is the success rate of thoracoscopic repair for congenital diaphragmatic hernia in neonates?
  2. What is the average operation time and blood loss for thoracoscopic repair of congenital diaphragmatic hernia in neonates?
  3. How many cases required conversion to open surgery during the study period?

Doctor’s Tip

A helpful tip a doctor might tell a patient about congenital diaphragmatic hernia repair is to closely follow all postoperative care instructions, including monitoring for signs of infection or complications, attending follow-up appointments, and avoiding heavy lifting or strenuous activities until fully cleared by the medical team. It is important to communicate any concerns or changes in symptoms to the healthcare provider promptly.

Suitable For

Patients with congenital diaphragmatic hernia, especially neonates, are typically recommended for thoracoscopic repair. This minimally invasive surgical approach has been shown to be effective in treating left and right diaphragmatic hernias, with a high success rate and low complication rate. Patients who are diagnosed prenatally or soon after birth can benefit from early intervention with thoracoscopic repair, leading to improved outcomes and a higher cure rate. Overall, thoracoscopic repair is considered a first-choice treatment for congenital diaphragmatic hernia in neonates.

Timeline

Before congenital diaphragmatic hernia repair, patients may experience symptoms such as difficulty breathing, rapid breathing, cyanosis, and a sunken chest. Diagnosis may be made prenatally through ultrasound or after birth through physical examination and imaging studies. Surgery is typically performed within the first few days of life to repair the hernia and reposition the abdominal organs back into the abdomen.

After congenital diaphragmatic hernia repair, patients may require mechanical ventilation to support their breathing for a few days to allow the repaired diaphragm to heal. The average postoperative mechanical ventilation time is around 3.9 days. Patients are closely monitored for any complications, such as respiratory distress, infection, or recurrence of the hernia. The overall cure rate for congenital diaphragmatic hernia repair is reported to be 89.4%, with most patients successfully recovering and being discharged from the hospital.

What to Ask Your Doctor

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

  1. What are the risks and benefits of thoracoscopic repair compared to traditional open surgery for treating congenital diaphragmatic hernia?
  2. What is the success rate of thoracoscopic repair in neonates with congenital diaphragmatic hernia?
  3. How long is the recovery time after thoracoscopic repair surgery?
  4. Are there any potential long-term complications or side effects associated with thoracoscopic repair for congenital diaphragmatic hernia?
  5. What type of follow-up care or monitoring is needed after the surgery?
  6. How experienced is the medical team in performing thoracoscopic repair for congenital diaphragmatic hernia?
  7. Are there any specific dietary or lifestyle changes that should be made post-surgery to aid in recovery?
  8. What is the expected outcome for the patient after thoracoscopic repair surgery for congenital diaphragmatic hernia?
  9. Are there any alternative treatment options available for congenital diaphragmatic hernia, and if so, what are the pros and cons of each option?
  10. What is the likelihood of the hernia reoccurring after thoracoscopic repair surgery, and how is this risk managed?

Reference

Authors: Wang H, Liu X, Wang H, Hu Y, Wu Y. Journal: Zhejiang Da Xue Xue Bao Yi Xue Ban. 2018 May 25;47(3):283-288. doi: 10.3785/j.issn.1008-9292.2018.06.11. PMID: 30226330