Skip to main content
SpringerLink
Log in

The feasibility and safety of same-day surgery for diaphragmatic eventration by minithoracotomy in children

  • Original Article
  • Published:
Pediatric Surgery International Aims and scope Submit manuscript

Abstract

Purpose

The diaphragmatic plication procedure by thoracoscopy has gradually become standard treatment for diaphragmatic eventration (DE). However, thoracoscopic diaphragmatic plication is difficult to manipulate and the surgical learning curve is long. This study aimed to demonstrate the feasibility and safety of same-day surgery for DE by minithoracotomy in children.

Methods

From December 2017 to December 2019, we included 22 patients who underwent diaphragmatic plication of DE in the Department of Pediatric Thoracic Surgery at the Guangzhou Women and Children’s Medical Center. A total of 10 patients underwent diaphragmatic plication by minithoracotomy and 12 patients underwent thoracoscopic plication. The perioperative condition and postoperative follow-up were evaluated, respectively.

Results

The age, sex, and weight were no different in the minithoracotomy group versus the thoracoscopy group (P > 0.05). The intraoperative time, blood loss volume, and postoperative hospital stay of the minithoracotomy group were significantly less than that of the thoracoscopy group (31.10 ± 4.70 min vs. 72.08 ± 22.8 min; 1.20 ± 0.42 ml vs. 2.58 ± 1.67 ml; and 1.00 ± 0.00 days vs. 6.00 ± 2.95 days, respectively, all P < 0.05). The eventration levels in these two groups were significantly different in the perioperative and postoperative periods as detected by chest X-ray. No chest tubes were inserted and no recurrence of DE occurred in the thoracoscopy group through the postoperative follow-up of at least 6 months.

Conclusion

Same-day surgery by minithoracotomy as a treatment for DE was feasible and safe with less operative time, less blood loss, and low recurrence. Same-day surgery for DE was attributed to a quick recovery. More prospective studies are necessary to further explore the consequences of same-day surgery for DE by minithoracotomy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Groth SS, Andrade RS (2009) Diaphragmatic eventration. Thorac Surg Clin 19(4):511–519

    Article  Google Scholar 

  2. Heiwegen K, van Heijst AF, Daniels-Scharbatke H, van Peperstraten MC, de Blaauw I, Botden SM (2020) Congenital diaphragmatic eventration and hernia sac compared to CDH with true defects: a retrospective cohort study. Eur J Pediatr 179(6):855–863

    Article  Google Scholar 

  3. Özkan S, Yazici Ü, Aydin E, Karaoğlanoğlu N (2016) Is surgical plication necessary in diaphragm eventration? Asian J Surg 39(2):59–65

    Article  Google Scholar 

  4. Joshi A, Kumar M, Acharya A (2018) Bilateral congenital eventration of diaphragm: keep in mind, the other side. BMJ Case Rep. https://doi.org/10.1136/bcr-2018-226051

    Article  PubMed  PubMed Central  Google Scholar 

  5. Tsugawa C, Kimura K, Nishijima E, Muraji T, Yamaguchi M (1997) Diaphragmatic eventration in infants and children: is conservative treatment justified? J Pediatr Surg 32(11):1643–1644

    Article  CAS  Google Scholar 

  6. Parlak A, Gurpinar AN, Dogruyol H (2020) Double purse-string suturing: an easy plication technique in thoracoscopic repair of diaphragmatic eventration. J Pediatr Surg 55(5):967–971

    Article  Google Scholar 

  7. Kim DH, Sung SC, Kim H, Choi KH, Son BS, Park JM et al (2020) Is the pleating technique superior to the invaginating technique for plication of diaphragmatic eventration in infants? J Pediatr Surg. https://doi.org/10.1016/j.jpedsurg.2020.07.015

    Article  PubMed  Google Scholar 

  8. Becmeur F, Talon I, Schaarschmidt K, Philippe P, Moog R, Kauffmann I et al (2005) Thoracoscopic diaphragmatic eventration repair in children: about 10 cases. J Pediatr Surg 40(11):1712–1715

    Article  Google Scholar 

  9. Hu J, Wu Y, Wang J, Zhang C, Pan W, Zhou Y (2013) Thoracoscopic and laparoscopic plication of the hemidiaphragm is effective in the management of diaphragmatic eventration. Pediatr Surg Int 30(1):19–24

    Article  Google Scholar 

  10. Jeanty C, Nien JK, Espinoza J, Kusanovic JP et al (2007) Pleural and pericardial effusion: a potential ultrasonographic marker for the prenatal differential diagnosis between congenital diaphragmatic eventration and congenital diaphragmatic hernia. Ultrasound Obstet Gynecol 29(4):378–387

    Article  CAS  Google Scholar 

  11. Rejab H, Trigui A, Mzali R (2019) Rare, everted liver in a patient with diaphragmatic eventration. Clin Gastroenterol Hepatol 17(13):e154

    Article  Google Scholar 

  12. Balci AE, Ozyurtkan MO (2010) Clinical and surgical specifications of adult unilateral diaphragmatic eventration according to their aetiology in 28 patients. Importance of using diaphragmatic patch and minimal thoracotomy incision. Eur J Cardiothorac Surg 37(3):606–612

    Article  Google Scholar 

  13. Bin Asaf B, Kodaganur Gopinath S, Kumar A, Puri HV, Pulle MV, Bishnoi S (2020) Robotic diaphragmatic plication for eventration: a retrospective analysis of efficacy, safety, and feasibility. Asian J Endosc Surg 14:70–76

    Article  Google Scholar 

  14. Gupta A, Sidler M, van Poll D, Patel N, Eaton S, Muthialu N et al (2020) Thoracic versus abdominal approach to correct diaphragmatic eventration in children. J Pediatr Surg 55(2):245–248

    Article  Google Scholar 

  15. Xu PP, Chang XP, Tang ST, Li S, Cao GQ, Zhang X et al (2020) Robot-assisted thoracoscopic plication for diaphragmatic eventration. J Pediatr Surg 55:2787

    Article  Google Scholar 

Download references

Funding

No funding supports was got.

Author information

Authors and Affiliations

  1. Department of Pediatric Thoracic Surgery, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, 510623, Guangdong, China

    Dongmei Huang, Jue Tang, Fenghua Wang, Le Li, Jianhua Liang, Linwei Zhuang, Qinglin Yang, Jiahang Zeng & Wei Liu

Authors
  1. Dongmei Huang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jue Tang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Fenghua Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Le Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jianhua Liang
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Linwei Zhuang
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Qinglin Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Jiahang Zeng
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Wei Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Wei Liu.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Huang, D., Tang, J., Wang, F. et al. The feasibility and safety of same-day surgery for diaphragmatic eventration by minithoracotomy in children. Pediatr Surg Int 37, 1215–1220 (2021). https://doi.org/10.1007/s00383-021-04907-0

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00383-021-04907-0

Keywords

Search

Navigation