| Minimally invasive repair of congenital diaphragmatic hernia. | |
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MedLine Citation:
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PMID: 21683215 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: Operative approach, including minimally invasive surgery (MIS) in the repair of congenital diaphragmatic hernia (CDH), is variable among institutions. The short-term recurrent hernia rate is not well described. We evaluated the in-hospital recurrence rate of MIS repairs of infants with CDH from the Congenital Diaphragmatic Hernia Registry. METHODS: Prospectively collected data from infants with CDH were analyzed from the Congenital Diaphragmatic Hernia Registry from January 1995 to January 2010. Recurrent hernia was defined as reoperations during initial hospitalization. Operative approaches included abdominal, thoracic, laparoscopic, and thoracoscopic techniques. RESULTS: Five thousand four hundred eighty infants with CDH were identified, of which 4516 (82.4%) were repaired. Operative data were available in 4390 infants. One hundred fifty-one infants (3.4%) underwent MIS repairs with 12 reported recurrences (7.9%) compared with 114 for open techniques (2.7%, P < .05). Minimally invasive surgery demonstrated a significant increased odds for recurrence (odds ratio, 3.59; 95% confidence interval, 1.92-6.71) after adjusting for gestational age, birth weight, patch repair, and extracorporeal membrane oxygenation. CONCLUSION: Minimally invasive techniques appear to have a significant higher recurrent hernia rate, with thoracoscopy being the highest. Although adjusted for patch repair, other factors with regard to disease severity may contribute to differences in outcomes among centers. This study is limited to short-term recurrence during initial hospitalization. |
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Authors:
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KuoJen Tsao; Pamela A Lally; Kevin P Lally; |
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Publication Detail:
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Type: Comparative Study; Evaluation Studies; Journal Article; Multicenter Study |
Journal Detail:
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Title: Journal of pediatric surgery Volume: 46 ISSN: 1531-5037 ISO Abbreviation: J. Pediatr. Surg. Publication Date: 2011 Jun |
Date Detail:
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Created Date: 2011-06-20 Completed Date: 2011-10-31 Revised Date: 2013-05-24 |
Medline Journal Info:
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Nlm Unique ID: 0052631 Medline TA: J Pediatr Surg Country: United States |
Other Details:
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Languages: eng Pagination: 1158-64 Citation Subset: IM |
Copyright Information:
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Published by Elsevier Inc. |
Affiliation:
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Department of Pediatric Surgery, The University of Texas School of Medicine at Houston, Houston, TX 77030, USA. kuojen.tsao@uth.tmc.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Analysis of Variance Cohort Studies Confidence Intervals Female Follow-Up Studies Hernia, Diaphragmatic / congenital*, diagnosis, mortality, surgery Humans Infant Infant, Newborn Laparoscopy / adverse effects, methods Length of Stay Male Odds Ratio Postoperative Complications / epidemiology, physiopathology Recurrence / prevention & control Registries Reoperation / statistics & numerical data Surgical Procedures, Minimally Invasive / adverse effects, methods* Survival Rate Thoracoscopy / adverse effects, methods* Treatment Outcome United States |
| Grant Support | |
ID/Acronym/Agency:
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L40 HD062427-01/HD/NICHD NIH HHS |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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