ANATOMICAL VARIATIONS OF CONGENITAL DIAPHRAGMATIC HERNIA DURING THORACOSCOPIC REPAIR :A TWO EGYPTIAN CENTERS EXPERIENCE | ||||
| Zagazig University Medical Journal | ||||
| Article 19, Volume 25, Issue 3, May 2019, Page 430-438 PDF (256.36 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/zumj.2019.30948 | ||||
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| Authors | ||||
| Ahmed Osama Hassan; Ahmed Ezzat Mohamed Rozik; Ismail Mohamed Ali Tantawy; Mohamed Magdy El Barbary | ||||
| Abstract | ||||
| Background: Congenital diaphragmatic hernia is a major problem in pediatric patients specially neonates with subsequent high morbidity and mortality. Thoracoscopic repair is now being considered the primary choice in management of such patients. The present work aims at evaluating the different anatomical characteristics and variations of congenital diaphragmatic defects during thoracoscopic repair. Methods: Thirty patients with congenital diaphragmatic hernia were included in the study. Thoracoscopic inspection of the defect and its anatomical characters was followed by repair. Data were recorded regarding symptoms, radiological findings, anatomic landmarks and variations during the procedure itself. Results: A higher incidence of congenital diaphragmatic hernia in infantile male population was documented with a higher incidence of left sided defect (96.7%). Postero-lateraldefects were common (86.7%) compared to lateral defect. Hernial sac was absent in 90% of cases. Most of cases had anterolateral muscular rim (86.7%). Liver herniation occurred in only two cases (6.7%). The majority of patients had moderate organ displacement (70%). Thoracoscopic repair was successful in 90% of cases. Primary repair was done in all cases with no need of synthetic patches. Conclusion: The use of thoracoscope helps in creation of a strict phenotyping system that will enhance the ability to predict the clinical course of diaphragmatic defects and will aid in identifying developmental pathways responsible for the disease. | ||||
| Keywords | ||||
| Congenital diaphragmatic hernia; Thoracoscope; Diaphragmatic defect; Hernial sac; Liver herniation | ||||
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