Thoracoscopic repair of congenital diaphragmatic hernia in neonates: findings of a multicenter study in Japan View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2021-04-20

AUTHORS

Manabu Okawada, Satoko Ohfuji, Masaya Yamoto, Naoto Urushihara, Keita Terui, Kouji Nagata, Tomoaki Taguchi, Masahiro Hayakawa, Shoichirou Amari, Kouji Masumoto, Tadaharu Okazaki, Noboru Inamura, Katsuaki Toyoshima, Mikihiro Inoue, Taizo Furukawa, Akiko Yokoi, Yutaka Kanamori, Noriaki Usui, Yuko Tazuke, Ryuta Saka, Hiroomi Okuyama

ABSTRACT

PurposeWe compared the efficacy of thoracoscopic repair (TR) with that of open repair (OR) for neonatal congenital diaphragmatic hernia (CDH).MethodsThe subjects of this multicenter retrospective cohort study were 524 infants with left-sided isolated CDH, diagnosed prenatally, and treated at one of 15 participating hospitals in Japan between 2006 and 2018. The outcomes of infants who underwent TR and those who underwent OR were compared, applying propensity score matching.ResultsDuring the study period, 57 infants underwent TR and 467 underwent OR. Ten of the infants who underwent TR required conversion to OR for technical difficulties and these patients were excluded from the analysis. The survival rate at 180 days was similar in both groups (TR 98%; OR 93%). Recurrence developed after TR in 3 patients and after OR in 15 patients (TR 7%, OR 3%, p = 0.40). The propensity score was calculated using the following factors related to relevance of the surgical procedure: prematurity (p = 0.1), liver up (p < 0.01), stomach position (p < 0.01), and RL shunt (p = 0.045). After propensity score matching, the multivariate analysis adjusted for severity classification and age at surgical treatment revealed a significantly shorter hospital stay (odds ratio 0.50) and a lower incidence of chronic lung disease (odds ratio 0.39) in the TR group than in the OR group.ConclusionsTR can be performed safely for selected CDH neonates with potentially better outcomes than OR. More... »

PAGES

1694-1702

Journal

TITLE

Surgery Today

ISSUE

10

VOLUME

51

Author Affiliations

  • Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, Tokyo, Japan
  • Department of Public Health, Osaka City University Graduate School of Medicine, 2-2 Yamadaoka, 565-0871, Suita, Osaka, Japan
  • Department of Pediatric Surgery, Shizuoka Children’s Hospital, Shizuoka, Japan
  • Department of Pediatric Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
  • Department of Pediatric Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
  • Center for Maternal-Neonatal Care, Nagoya University Hospital, Nagoya, Japan
  • Division of Neonatology, National Center for Child Health and Development, Tokyo, Japan
  • Department of Pediatric Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
  • Department of Pediatric Surgery, Juntendo University Urayasu Hospital, Chiba, Japan
  • Department of Pediatrics, Faculty of Medicine, Kinki University, Osaka-Sayama, Japan
  • Departments of Neonatology, Kanagawa Children’s Medical Center, Yokohama, Japan
  • Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine, Tsu, Japan
  • Department of Pediatric Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
  • Department of Pediatric Surgery, Kobe Children’s Hospital, Hyogo, Japan
  • Division of surgery, National Center for Child Health and Development, Tokyo, Japan
  • Department of Pediatric Surgery, Osaka Women’s and Children’s Hospital, Izumi, Japan
  • Department of Pediatric Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s00595-021-02278-6

    DOI

    http://dx.doi.org/10.1007/s00595-021-02278-6

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1137339686

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/33877452


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