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Thoracoscopic repair of right-sided congenital diaphragmatic hernia in the pediatric age: systematic review

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Abstract

Objective

Congenital diaphragmatic hernia (CDH) is an uncommon but potentially life-threatening surgical condition in neonates with right-sided CDH being less common. This review aimed to analyze the outcomes of thoracoscopic repairs in right-sided congenital diaphragmatic hernia (RCDH) in pediatric patients.

Methods

PubMed and Science Direct databases were searched. Articles were identified and selected for thoracoscopic repair in RCDH in the pediatric age with relevant literature published from 2002 to 2022 and analyzed by 2 Reviewers.

Results

The review identified 13 articles and offered a total of 70 patients (aged 2 days to 15 years) with RCDH with attempted thoracoscopic repair. Data was analyzed with regard to (a) herniated organs: liver (n = 44), bowel (n = 2), liver and bowel (n = 1), liver and kidney (n = 1), liver and intralobar sequester (ILS) (n = 1) and no data (n = 21); (b) suture material for repair: non-absorbable braided polyester (Ethibond®) 2/0 or 3/0 (n = 20) and no data (n = 46); (c) primary repairs: n = 26 and no data (n = 40); (d) patch repairs: n = 4 with Gore-Tex®; (e) conversions: total 3, thoracoscopy to laparoscopy to reduce the liver (n = 1), to laparotomy due to desaturation (n = 1), and to laparoscopy due to the presence of an ILS and complex vascular abnormality (n = 1); (f) morbidity: pneumothorax (n = 1); (f) recurrences: no data available and (g) morbidity: septicemia (n = 1), postoperative respiratory distress (n = 1).

Conclusion

Scarce data exists on the thoracoscopic repair of RCDH. The liver is the predominant organ involved. Primary repairs have been reported in 1/3 cases with Ethibond® as the material of choice. Gore-Tex patch repair is reported in only 4 cases. Conversion rate, morbidity and mortality is low. Data in recurrences is missing.

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Data availability

Data analyzed in this study has been included in the references.

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  1. Department of Paediatric Surgery, Chelsea Children’s Hospital, Chelsea and Westminster Hospital NHS Foundation Trust, Imperial College London, 369 Fulham Road, London, SW10 9NH, UK

    Sherine Elsherbiny & Amulya K. Saxena

  2. Department of Paediatric Surgery, University of Magdeburg, Magdeburg, Germany

    Sherine Elsherbiny

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  1. Sherine Elsherbiny
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Elsherbiny, S., Saxena, A. Thoracoscopic repair of right-sided congenital diaphragmatic hernia in the pediatric age: systematic review. J Ped Endosc Surg 6, 65–69 (2024). https://doi.org/10.1007/s42804-023-00205-9

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  • DOI: https://doi.org/10.1007/s42804-023-00205-9

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