Thoracoscopic CDH Repair--A Survey on Opinion and Experience Among IPEG Members.
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 of laparoendoscopic & advanced surgical techniques. Part A
Clinical Competence; Hernias, Diaphragmatic, Congenital; Herniorrhaphy; Humans; Recurrence; Retrospective Studies; Surveys and Questionnaires; Thoracoscopy; Treatment Outcome
International Pediatric Endosurgery Group (IPEG)
Lacher M, St Peter SD, Laje P, Harmon CM, Ure B, Kuebler JF. Thoracoscopic CDH Repair--A Survey on Opinion and Experience Among IPEG Members. J Laparoendosc Adv Surg Tech A. 2015;25(11):954-957. doi:10.1089/lap.2015.0243