Journal of Developmental Medicine(Electronic Version)  2025, Vol. 13 Issue (4): 276-281 DOI: 10.3969/j.issn.2095-5340.2025.04.005 |
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| Analysis of the effect of hernia needle-assisted thoracoscopic diaphragm plication in the treatment of congenital diaphragm eventration |
| Li Guang, Zhang Yanping, Liu Gang, et al
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(Beijing Key Laboratory of Pediatric Organ Failure, National Engineering Laboratory for Birth Defects Prevention and Control of Key Technology, Institute of Pediatrics, the Seventh Medical Center of Chinese PLA General Hospital, Faculty of Pediatrics, Chinese PLA General Hospital, Beijing 100700, China)
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Abstract 【Abstract】 Objective To explore the efficacy of hernia needle-assisted thoracoscopic diaphragmatic plication in the treatment of congenital diaphragmatic eventration. Method A total of 40 children diagnosed with diaphragmatic eventration and undergoing diaphragmatic plication at the Seventh Medical Center of Chinese PLA General Hospital from January 2015 to July 2024 were selected as study subjects. They were randomly divided into the study group and the control group according to the random numbertable method, with 20 cases in each group. The study group received hernia needle-assisted thoracoscopic diaphragmatic plication, while the control group underwent traditional thoracoscopic diaphragmatic plication.
The following parameters were compared between the two groups: intraoperative blood loss, incision length, operative time, postoperative mechanical ventilation duration, time for removing the thoracic drainage tube, postoperative feeding time, hospital stay, postoperative recurrence rate, and survival rate. Statistical analysis was performed by independent samples t-test, χ2test. Result There were no statistically significant differences in gender, gestational age, birth weight, and lesion site between the infants in the study group and the control group (all P>0.05). The intraoperative blood loss in the study group was less than that in the control group [(2.12±0.41) ml vs (3.02±0.56) ml, t=-5.012, P=0.002]. The incision length [(1.59±0.39) cm vs (2.77±0.42) cm, t=-6.474, P=0.015], operation time [(79.91±10.15) min vs (93.22±7.84) min, t=-3.279, P=0.023], postoperative mechanical ventilation time [(1.32±0.32) d vs (1.64±0.67) d, t=-5.186, P=0.044], postoperative feeding time [(1.61±0.29) d vs (1.95±0.27) d, t=-2.762, P=0.032], time for removing the thoracic drainage tube [(3.08±0.50) d vs (3.21±0.44) d, t=-3.615, P=0.019], and hospital stay [(12.80±0.33) dvs (16.12±0.47) d, t=-3.328, P=0.044] in the study group were all shorter than those in the control group, with statistically significant differences. After surgery, all 20 cases in the study group were cured and discharged, and no recurrence was found during follow-up. However, 1 case died of sepsis 1 month after
discharge during follow-up. All 20 cases in the control group were cured and discharged, and 2 cases recurred 4 months after surgery during follow-up. There was no statistically significant difference in the recurrence rate between the two groups (P>0.05). Conclusion Hernia needle-assisted thoracoscopic diaphragmatic plication for treating congenital diaphragmatic eventration demonstrates minimal surgical trauma, reduces blood loss, shortens both operative time and hospital stay, and proves to be safe and effective. This technique achieves the anticipated surgical advantages and is worthy of clinical promotion.
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Received: 02 December 2024
Published: 31 July 2025
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