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Updated: Jun 21, 2025
Laparoscopic Repair of Para-Esophageal Hernia Using Absorbable Biosynthetic Mesh
Published on: September 11, 2021
Comprehensive meta-analysis of surgical procedure for congenital diaphragmatic hernia: thoracoscopic versus open
Soichi Shibuya1,2, Irene Paraboschi3, Stefano Giuliani4
1Stem Cell and Regenerative Medicine Section, Developmental Biology and Cancer Research & Teaching Department, Zayed Centre for Research Into Rare Disease in Children, Great Ormond Street Institute of Child Health, University College London, 30 Guilford Street, London, WC1N 1E, UK. soshibu@juntendo.ac.jp.
Purpose:
Previous studies have shown a higher recurrence rate and longer operative times for thoracoscopic repair (TR) of congenital diaphragmatic hernia (CDH) compared to open repair (OR). An updated meta-analysis was conducted to re-evaluate the surgical outcomes of TR.
Methods:
A comprehensive literature search comparing TR and OR in neonates was performed in accordance with the PRISMA statement (PROSPERO: CRD42020166588).
Results:
Fourteen studies were selected for quantitative analysis, including a total of 709 patients (TR: 308 cases, OR: 401 cases). The recurrence rate was higher [Odds ratio: 4.03, 95% CI (2.21, 7.36), p < 0.001] and operative times (minutes) were longer [Mean Difference (MD): 43.96, 95% CI (24.70, 63.22), p < 0.001] for TR compared to OR. A significant reduction in the occurrence of postoperative bowel obstruction was observed in TR (5.0%) compared to OR (14.8%) [Odds ratio: 0.42, 95% CI (0.20, 0.89), p = 0.02].
Conclusions:
TR remains associated with higher recurrence rates and longer operative times. However, the reduced risk of postoperative bowel obstruction suggests potential long-term benefits. This study emphasizes the importance of meticulous patient selection for TR to mitigate detrimental effects on patients with severe disease.
