Thoracoscopic repair with simplified mattress sutures in the treatment of diaphragmatic hernia in neonates without posterolateral rim of diaphragm
Li Bing, Chen Weibing, Xia Shunlin, Liu Mengxu, Wang Shouqing
Published 2020-03-01
Cite as Chin J Prim Med Pharm, 2020,27(05): 550-554. DOI: 10.3760/cma.j.issn.1008-6706.2020.05.009
Abstract
ObjectiveTo explore the initial experience of thoracoscopic repair with simplified mattress sutures in the treatment of diaphragmatic hernia in neonates without posterolateral rim of diaphragm.
MethodsA retrospective review of the new simplified technique in 10 cases from March 2015 to October 2017 was performed.Of the patients, 6 cases were male, 4 cases were female.The age was 10min-1d, 7 cases were term newborns, and 3 cases were premature.The mean weight was 2.88 kg(ranged 2.3-3.5kg). All the 4 cases were left-sided.Two to three primary suture sites were taken from the relative intercostal region of the body surface projection of the defect.A snip incision about 1 mm of the skin was done.Two 2-0 non-absorbable sutures round the rib were inserted between the front edged of the defect and the diaphragm muscle through a syringe needle.The first thread was brought out of the body by the ring of the second thread and knot tying was made extracorporally.The posterolateral defect was closed; the knot was under the skin of intercostals space.
ResultsTen neonates with CDH were repaired successfully using this new simplified technique.The mean operative time was 37.5min(ranged 25-60min) for each CDH repair.No cases required conversion to open surgery, blood loss was minimal.The 10 cases were followed up for 16.5 months(ranged 5-24 months), with no death and no recurrence.One neonate complicated with subcutaneous emphysema postoperatively and healed in one week.
ConclusionThe new technique of thoracoscopic repairing with simplified mattress sutures when no posterolateral rim of diaphragm exists has all the advantages of thoracoscopy in neonates combined with the advantages of reduced operative time, simplicity, feasibility and definite curative effect and has the value of clinical popularization.
Key words:
Hernia, diaphragmatic; Thoracoscopy; Reconstructive surgical procedures; Infant, newborn
Contributor Information
Li Bing
Department of Pediatric Surgery, the Women and Children′s Hospital of Huai′an, Huai′an, Jiangsu, 223002, China
Chen Weibing
Department of Pediatric Surgery, the Women and Children′s Hospital of Huai′an, Huai′an, Jiangsu, 223002, China
Xia Shunlin
Department of Pediatric Surgery, the Women and Children′s Hospital of Huai′an, Huai′an, Jiangsu, 223002, China
Liu Mengxu
Department of Pediatric Surgery, the Women and Children′s Hospital of Huai′an, Huai′an, Jiangsu, 223002, China
Wang Shouqing
Department of Pediatric Surgery, the Women and Children′s Hospital of Huai′an, Huai′an, Jiangsu, 223002, China
