Comprehensive meta-analysis of surgical procedure for congenital diaphragmatic hernia: thoracoscopic versus open repair.
Pediatr Surg Int
; 40(1): 182, 2024 Jul 09.
Article
en En
| MEDLINE
| ID: mdl-38980431
ABSTRACT
PURPOSE:
Previous studies have shown a higher recurrence rate and longer operative times for thoracoscopic repair (TR) of congenital diaphragmatic hernia (CDH) compared to open repair (OR). An updated meta-analysis was conducted to re-evaluate the surgical outcomes of TR.METHODS:
A comprehensive literature search comparing TR and OR in neonates was performed in accordance with the PRISMA statement (PROSPERO CRD42020166588).RESULTS:
Fourteen studies were selected for quantitative analysis, including a total of 709 patients (TR 308 cases, OR 401 cases). The recurrence rate was higher [Odds ratio 4.03, 95% CI (2.21, 7.36), p < 0.001] and operative times (minutes) were longer [Mean Difference (MD) 43.96, 95% CI (24.70, 63.22), p < 0.001] for TR compared to OR. A significant reduction in the occurrence of postoperative bowel obstruction was observed in TR (5.0%) compared to OR (14.8%) [Odds ratio 0.42, 95% CI (0.20, 0.89), p = 0.02].CONCLUSIONS:
TR remains associated with higher recurrence rates and longer operative times. However, the reduced risk of postoperative bowel obstruction suggests potential long-term benefits. This study emphasizes the importance of meticulous patient selection for TR to mitigate detrimental effects on patients with severe disease.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Toracoscopía
/
Herniorrafia
/
Hernias Diafragmáticas Congénitas
Límite:
Humans
/
Newborn
Idioma:
En
Revista:
Pediatr Surg Int
Asunto de la revista:
PEDIATRIA
Año:
2024
Tipo del documento:
Article
País de afiliación:
Reino Unido