Thoracoscopic Treatment of Congenital Diaphragmatic Eventration in Children: Lessons Learned After 15 Years of Experience

Abstract

Introduction We present our experience with the thoracoscopic treatment of congenital diaphragmatic eventration (CDE) in children through 15 years to evaluate the efficiency of the procedure and the potential risk of recurrence.

Materials and Methods We reviewed the medical files of patients treated for CDE through thoracoscopy from 2000 to 2011. Age at surgery, sex, side of the lesion, procedure's details, postoperative course, and complications were analyzed. Mean follow-up was 12 months.

Results In this study, eight patients (five males and three females) aged from 6 months to 7 years underwent thoracoscopic plication for six right and two left eventrations; one conversion was necessary due to a too small operative field. Mean operative time was 60.5 minutes. A chest drainage was placed in six patients. We observed two recurrences from which the first one was treated thoracoscopically by endostapler resection/suturing and the other one by laparotomy. At follow-up, all patients were asymptomatic with a correct level of the diaphragm.

Conclusions Thoracoscopic plication is feasible and safe, and we consider this approach as the gold standard for the treatment of CDE. However, we still need to carefully consider the possibility of introducing certain modifications to reduce the potential risk of recurrence.

Keywords

congenital diaphragmatic eventration - thoracoscopy - plication - endostapler

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