未经证实:先天性膈疝(CDH)是一种在新生儿中具有显著发病率的异常。传统上,它是通过开放式方法进行管理的,最近的趋势是微创方法。
UNASSIGNED:这是我们对新生儿胸腔镜治疗CDH的机构经验的回顾性研究,几乎没有技术细微差别的影响。
UNASSIGNED:收集了2015年1月至2018年12月之间新生儿胸腔镜CDH修复的数据,术中参数,术后状态,复发,和死亡率。在分析数据时,我们发现外科医生采用的技术修改很少,例如修剪缺损的边缘,使用假肢网覆盖层加强在张力下进行修理,更喜欢体外打结以及更高的套管针位置,暂时增加二氧化碳,最大限度地使用肌肉松弛剂,在某个时候,身体外的角落挂接缝线,并继续处理其他案件。进行了内部比较,以分析影响结果的技术修改,把他们分成两组,有(A组)和没有修饰(B组)的那些。使用SPSS软件(IBM,版本23)。P值<0.05被认为具有统计学意义。
UNASSIGNED:45例新生儿中64.4%为男性,平均出生体重2.6公斤。两组之间的基线变量具有可比性。使用更高级别的摄像机端口后,操作时间显着减少(P值:0.0001)。平均随访30.8个月。共有7次复发(A组6次,B组1次),全部在12个月内七名父母给出了治疗后的总体反馈,即“不满意”。操作时间,复发率,B组家长满意度反馈明显较少(P值:0.001)。
UNASSIGNED:我们建议修剪缺陷的边缘,使用假肢网覆盖层加强在张力下进行修理,更喜欢体外打结以及更高的套管针位置,暂时增加二氧化碳,最大限度地使用肌肉松弛剂,体外角挂接缝线,以减少操作时间,胸腔镜CDH修补术后复发。
UNASSIGNED: Congenital diaphragmatic hernia (CDH) is an anomaly with significant morbidity in neonates. It has been traditionally managed by an open approach with a recent trend toward a minimally invasive approach.
UNASSIGNED: This is a retrospective study of our institutional experience with neonatal thoracoscopic management of CDH, with the impact of few technical nuances.
UNASSIGNED: The data was collected on neonatal thoracoscopic CDH repair between January 2015 and December 2018, in terms of the demographics, intra-operative parameters, post-operative status, recurrence, and mortality. While analyzing data, we found few technical modifications adopted by the surgeon such as trimming the margin of the defect, use of prosthetic mesh overlay reinforcement for repairs under tension, and to prefer extra-corporeal knotting along with higher placement of trocar, temporary increase in CO2, maximal use of muscle relaxant, extra-corporeal corner hitch stitch at some point, and continuation for further cases. An internal comparison was made to analyze the technical modifications influencing the outcomes, by dividing them into two groups, those with (group A) and without modifications (group B). The data was analyzed using SPSS software (IBM, Version 23). A P value of <0.05 was considered statistically significant.
UNASSIGNED: Out of 45 newborns 64.4% were males with an average birth weight of 2.6 kg. Baseline variables were comparable between the groups. The operating time significantly reduced after a higher-level camera port was used (P-value: 0.0001). The mean follow-up was 30.8 months. There were totally seven recurrences (6 in group A and 1 in group B), all within 12 months. Seven parents gave the overall post-treatment feedback as \"unsatisfied\". The operating time, recurrence rate, and parental satisfaction feedback were significantly less in group B (P-value: 0.001).
UNASSIGNED: We recommend trimming the margin of the defect, use of prosthetic mesh overlay reinforcement for repairs under tension, and to prefer extra-corporeal knotting along with higher placement of trocar, temporary increase in CO2, maximal use of muscle relaxant, extra-corporeal corner hitch stitch to reduce the operating time, and recurrence after thoracoscopic CDH repair.