Minimally Invasive Approach Versus Traditional Approach for Treating Congenital Diaphragmatic Hernia: A Systematic...

Area of Science:

• Pediatric Surgery
• Thoracic Surgery
• Medical Technology Assessment

Background:

• Congenital diaphragmatic hernia (CDH) is a critical surgical condition.
• Management options include open and thoracoscopic repair.
• Optimal surgical approach for CDH remains debated.

Purpose of the Study:

• To compare the efficacy and safety of thoracoscopic versus open repair for CDH.
• To evaluate key outcomes including hospital stay, operation time, mortality, and recurrence.

Main Methods:

• Systematic literature review of four databases (PubMed, Web of Science, Scopus, Cochrane Library).
• Inclusion of 35 studies with 1,680 CDH patients comparing thoracoscopic and open repair.
• Meta-analysis of hospital stay duration, operation time, mortality, and recurrence rates.

Main Results:

• Thoracoscopic repair associated with shorter hospital stays (MD=-6.80) and lower mortality (RR=0.43).
• Thoracoscopic repair showed longer operation times (MD=23.30) and higher recurrence rates (RR=2.24).
• Statistical significance observed for all key outcomes (p<0.0001 for stay and recurrence, p=0.005 for time, p=0.004 for mortality).

Conclusions:

• Thoracoscopic CDH repair offers benefits of reduced hospital stay and mortality.
• Trade-offs include increased operation time and higher recurrence rates.
• Further large-scale, multicenter randomized controlled trials are needed to confirm findings and guide clinical practice.