Diaphragmatic eventration in children: laparoscopy versus thoracoscopic plication

Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a
Go MiyanoNaoto Urushihara

Abstract

To determine the best way to perform diaphragmatic plication for diaphragmatic eventration (DE) using minimally invasive surgery. We conducted a retrospective review of pediatric cases of DE treated between 2007 and 2012. Thoracoscopic plication (TP) is performed using single-lung ventilation with three 5-mm ports; laparoscopic plication (LP) is performed using three or four 5-mm ports. The choice of technique was determined preferentially by the treating surgeon. There were 20 subjects (13 treated by LP and 7 treated by TP). Etiology of DE was phrenic nerve injury (LP, n=11; TP, n=1) and muscular deficiency (LP, n=2; TP, n=6). Mean age (LP, 18 months; TP, 25 months) and weight (LP, 8.0 kg; TP, 9.7 kg) at surgery were not significantly different. Mean operating time was 155.6 minutes in LP and 167.0 minutes in TP (P=not significant). Mean intraoperative end-tidal CO2 was 41.9 mm Hg (range, 35-52 mm Hg) in LP and 36.9 mm Hg (range, 33-41 mm Hg) in TP (P=.01). Mean duration of postoperative ventilation was 1.2 days in LP and 1.3 days in TP (P=not significant). Mean time taken to recommence feeding postoperatively was 1.6 days in both groups (P=not significant). Complications were one conversion to thoracotomy in TP, 1 case of ate...Continue Reading

References

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Citations

Jul 22, 2020·The Annals of Thoracic Surgery·Miyeong ParkYoung-Joon Lee
Nov 26, 2019·Journal of Pediatric Surgery·Alisha GuptaPaolo De Coppi

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Methods Mentioned

BETA
X-ray

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