TY - JOUR
T1 - Comprehensive meta-analysis of surgical procedure for congenital diaphragmatic hernia
T2 - thoracoscopic versus open repair
AU - Shibuya, Soichi
AU - Paraboschi, Irene
AU - Giuliani, Stefano
AU - Tsukui, Takafumi
AU - Matei, Andreea
AU - Olivos, Maricarmen
AU - Inoue, Mikihiro
AU - Clarke, Simon A.
AU - Yamataka, Atsuyuki
AU - Zani, Augusto
AU - Eaton, Simon
AU - De Coppi, Paolo
N1 - Publisher Copyright:
© The Author(s) 2024.
PY - 2024/12
Y1 - 2024/12
N2 - 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.
AB - 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.
KW - Bowel obstruction
KW - Congenital diaphragmatic hernia
KW - Meta-analysis
KW - Minimally invasive surgery
KW - Neonatal surgery
KW - Thoracoscopy
UR - https://www.scopus.com/pages/publications/85197808845
UR - https://www.scopus.com/inward/citedby.url?scp=85197808845&partnerID=8YFLogxK
U2 - 10.1007/s00383-024-05760-7
DO - 10.1007/s00383-024-05760-7
M3 - Article
C2 - 38980431
AN - SCOPUS:85197808845
SN - 0179-0358
VL - 40
JO - Pediatric Surgery International
JF - Pediatric Surgery International
IS - 1
M1 - 182
ER -