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Thoracoscopic plication for diaphragmatic eventration in a neonate
Tsubasa Takahashi1, Tadaharu Okazaki, Takanori Ochi
1Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, Tokyo, Japan. tsubasa@juntendo.ac.jp
Summary
Thoracoscopic plication (TP) is a safe and effective minimally invasive treatment for diaphragmatic eventration in neonates. This approach, performed under single-lung ventilation, offers excellent symptom resolution and should be considered for infants.
Area of Science:
- Pediatric Surgery
- Thoracic Surgery
- Neonatal Care
Background:
- Diaphragmatic eventration presents a significant respiratory challenge in neonates.
- Thoracoscopic plication (TP) is increasingly used for diaphragmatic eventration, but data in neonates is limited.
- This case highlights TP under single-lung ventilation in a neonate.
Observation:
- A 10-day-old neonate presented with respiratory distress due to right diaphragmatic eventration.
- Mechanical ventilation was required, with failed weaning attempts.
- Computed tomography confirmed an elevated right hemidiaphragm.
Findings:
- Thoracoscopic plication (TP) was successfully performed using a 3-port technique under single-lung ventilation on day 17 of life.
- The neonate experienced complete resolution of respiratory symptoms post-procedure.
- No recurrence of symptoms was observed at 9-month follow-up.
Implications:
- Thoracoscopic plication is a safe, effective, and minimally invasive option for symptomatic diaphragmatic eventration in neonates.
- Single-lung ventilation is feasible for TP in this age group.
- This technique should be actively considered for treating neonatal diaphragmatic eventration.
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