Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2024 Jul 9;40(1):182.
doi: 10.1007/s00383-024-05760-7.

Comprehensive meta-analysis of surgical procedure for congenital diaphragmatic hernia: thoracoscopic versus open repair

Soichi Shibuya  1   2 , Irene Paraboschi  3 , Stefano Giuliani  4 , Takafumi Tsukui  5 , Andreea Matei  6 , Maricarmen Olivos  7 , Mikihiro Inoue  8 , Simon A Clarke  7 , Atsuyuki Yamataka  5 , Augusto Zani  4   9 , Simon Eaton  10 , Paolo De Coppi  11   12
Affiliations
Meta-Analysis

Comprehensive meta-analysis of surgical procedure for congenital diaphragmatic hernia: thoracoscopic versus open repair

Soichi Shibuya et al. Pediatr Surg Int. .

Erratum in

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.

Keywords: Bowel obstruction; Congenital diaphragmatic hernia; Meta-analysis; Minimally invasive surgery; Neonatal surgery; Thoracoscopy.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA flow chart
Fig. 2
Fig. 2
Comparisons of recurrence rate. a Total recurrence. b Primary closure recurrence. c Patch repair recurrence
Fig. 3
Fig. 3
Comparisons of operative times. a Total operative times (minutes). b Operative times excluding conversions (minutes)
Fig. 4
Fig. 4
Comparisons of length of postoperative ventilation and total length of hospital stays. a Length of postoperative ventilation (days). b Total length of hospital stays (days)
Fig. 5
Fig. 5
Comparisons of occurrence of bowel obstruction. a Total bowel obstruction. b Bowel obstruction excluding conversions
See this image and copyright information in PMC

References

    1. Tennant PW, Pearce MS, Bythell M, Rankin J (2010) 20-year survival of children born with congenital anomalies: a population-based study. The Lancet 375:649–656. 10.1016/S0140-6736(09)61922-X - PubMed
    1. McGivern MR, Best KE, Rankin J et al (2015) Epidemiology of congenital diaphragmatic hernia in Europe: a register-based study. Arch Dis Child Fetal Neonatal Ed 100:F137–F144. 10.1136/archdischild-2014-306174 - PubMed
    1. Wang Y, Honeyford K, Aylin P et al (2019) One-year outcomes for congenital diaphragmatic hernia. BJS Open 3:305–313. 10.1002/bjs5.50135 - PMC - PubMed
    1. Lund DP, Mitchell J, Kharasch V et al (1994) Congenital diaphragmatic hernia: the hidden morbidity. J Pediatr Surg 29:258–264. 10.1016/0022-3468(94)90329-8 - PubMed
    1. Jancelewicz T, Chiang M, Oliveira C, Chiu PP (2013) Late surgical outcomes among congenital diaphragmatic hernia (CDH) patients: Why long-term follow-up with surgeons is recommended. J Pediatr Surg 48:935–941. 10.1016/j.jpedsurg.2013.02.005 - PubMed