Laparoscopic repair of incarcerated congenital diaphragmatic hernias presenting beyond the newborn period.
Document Type
Article
Publication Date
12-1-2012
Identifier
DOI: 10.1089/lap.2012.0052
Abstract
PURPOSE/BACKGROUND: Congenital diaphragmatic hernias (CDHs) diagnosed outside of the newborn period are an uncommon occurrence in developed countries. Incarceration of viscera presenting as bowel obstruction is a rare clinical scenario with only a few cases reported in the literature, all of which have been repaired via laparotomy. We have recently encountered a series of these cases that we approached laparoscopically.
SUBJECTS AND METHODS: We performed a retrospective review to identify patients who underwent laparoscopic repair of CDH with incarceration after the neonatal period. Demographics, presentation characteristics, operative details, and outcomes were reviewed. results: Between 2008 and 2011, three patients underwent laparoscopic repair of left-sided incarcerated CDH presenting with bowel obstruction. The mean age was 60.8 months (range, 2-157 months) with a mean weight of 30.2 kg (range, 11-66.5 kg). All cases were completed laparoscopically using a 5-mm umbilical port with three to four additional 3-mm instruments. The mean operative time was 133 minutes (range, 117-164 minutes). There were no intraoperative or postoperative complications. Mean length of hospital stay was 4 days (range, 1-8 days). Median follow-up was 6.3 months (range, 0.8-42.3 months). One patient suffered a recurrence after a motor vehicle collision and subsequently underwent a successful second laparoscopic repair.
CONCLUSIONS: The laparoscopic approach for patients presenting with an incarcerated CDH beyond the newborn period appears to be an appropriate approach and should be considered when this diagnosis is encountered.
Journal Title
Journal of laparoendoscopic & advanced surgical techniques. Part A
Volume
22
Issue
10
First Page
1014
Last Page
1016
MeSH Keywords
Age Factors; Child; Child, Preschool; Female; Hernia, Diaphragmatic; Hernias, Diaphragmatic, Congenital; Humans; Infant; Laparoscopy; Male; Retrospective Studies
Recommended Citation
Pettiford-Cunningham, J., Adibe, O. O., Gasior, A. C., Ostlie, D. J., St Peter, S. D. Laparoscopic repair of incarcerated congenital diaphragmatic hernias presenting beyond the newborn period. Journal of laparoendoscopic & advanced surgical techniques. Part A 22, 1014-1016 (2012).
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