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Open Access 01-12-2023 | Laparotomy | Original Article

Thoracoscopic vs open repair of congenital diaphragmatic hernia after extracorporeal membrane oxygenation: a comparison of intra-operative data

Authors: Annita Budzanowski, Stavros Loukogeorgakis, Dhanya Mullassery, Simon Blackburn, Joe Curry, Ioannis Ioannou, Usman Ali, Kate Cross, Stefano Giuliani, Paolo De Coppi

Published in: Pediatric Surgery International | Issue 1/2023

Abstract

Purpose

ECMO is an escalation treatment for hypoxic respiratory failure in patients with CDH. Open repair has been advocated after ECMO indicating that physiological changes associated to thoracoscopic repair were not well tolerated.

Methods

We have performed a retrospective review of all patients who underwent ECMO prior CDH repair over a 7 year period (2015–2021). Outcome measures were intra-operative Ph, PCO₂, PO₂ and FiO₂ at 30 min, 1 h 30 min, and 2 h 30 min of surgery, operative time and recurrence rate. Data are shown in median (range).

Results

Eleven patients required ECMO prior CDH repair. Six of eleven (55%) were done thoracoscopically (Group A) and five of eleven (45%) via laparotomy (Group B). Two of six (33%) patients (Group A) were converted to a laparotomy, one of six (16%) patient developed a recurrence, and there was no recurrence in Group B. Two of five (40%) patients died within the first 60 days of life, whilst there was no death in Group A. Intra-operative values are shown below.

Conclusion

Whilst this is a preliminary report of a limited number of patients, there is no obvious difference of intra-operative blood gas parameters during surgical repair in patients after ECMO. Thoracoscopic CDH repair may be considered in patients after ECMO.

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Title: Thoracoscopic vs open repair of congenital diaphragmatic hernia after extracorporeal membrane oxygenation: a comparison of intra-operative data
Authors: Annita Budzanowski
Stavros Loukogeorgakis
Dhanya Mullassery
Simon Blackburn
Joe Curry
Ioannis Ioannou
Usman Ali
Kate Cross
Stefano Giuliani
Paolo De Coppi
Publication date: 01-12-2023
Publisher: Springer Berlin Heidelberg
Keywords: Laparotomy
Laparotomy
Diaphragmatic Hernia
Diaphragmatic Hernia
ECMO
ECMO
Published in: Pediatric Surgery International / Issue 1/2023
Print ISSN: 0179-0358
Electronic ISSN: 1437-9813
DOI: https://doi.org/10.1007/s00383-022-05312-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Thoracoscopic vs open repair of congenital diaphragmatic hernia after extracorporeal membrane oxygenation: a comparison of intra-operative data

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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