Thoracoscopic CDH Repair--A Survey on Opinion and Experience Among IPEG Members.

Document Type

Article

Publication Date

11-1-2015

Identifier

DOI: 10.1089/lap.2015.0243

Abstract

BACKGROUND: Thoracoscopic repair of congenital diaphragmatic hernia (CDH) has become a popular approach. As there is an ongoing discussion on whether the benefits of the thoracoscopic repair outweigh the potential side effects, we aimed to investigate the opinion and experience of the members of the International Pediatric Endosurgery Group (IPEG) on this topic.

MATERIALS AND METHODS: An online survey was conducted between October and December 2013 on behalf of the IPEG Research Committee. All 536 IPEG members were contacted by e-mail and asked to complete an anonymous questionnaire that included 28 items on the management of CDH.

RESULTS: One hundred sixty-one pediatric surgeons completed the questionnaire. Contraindications to thoracoscopic repair included the following: patient on extracorporeal membrane oxygenation (ECMO) (78%); preoperative need for ECMO (42%); right-sided hernia (15%); liver in chest (32%); weight

CONCLUSIONS: Thoracoscopic CDH repair is currently being performed by 89% of all participating IPEG members. ECMO, either active or previously, and persistent right-to-left shunting are the main deterrents to thoracoscopic repair. The fact that only 50% of surgeons stated that CDH can be repaired equally by thoracoscopy and open surgery suggests that future studies should focus on identifying the appropriate patient population.

Journal Title

Journal of laparoendoscopic & advanced surgical techniques. Part A

Volume

25

Issue

11

First Page

954

Last Page

957

MeSH Keywords

Clinical Competence; Hernias, Diaphragmatic, Congenital; Herniorrhaphy; Humans; Recurrence; Retrospective Studies; Surveys and Questionnaires; Thoracoscopy; Treatment Outcome

Keywords

International Pediatric Endosurgery Group (IPEG)

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