الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
The prolific advances of minimal invasive surgery (MIS) have made many of the complex pediatric surgical problems amenable to these procedures for more benefits. Nowadays, successful repair of congenital diaphragmatic hernia (CDH) by thoracoscopic and laparoscopic techniques is not an exception.
Our study aims to highlight the surgical technique, initial results, and overview the indications of thoracoscopic repair of congenital diaphragmatic hernia (CDH).
This prospective study was conducted from August 2017 to July 2019 in 2 tertiary centers in Egypt. All confirmed CDH patients were assessed for the possibility of thoracoscopic repair. All delayed-onset cases, who presented after 48 hours, did not require either pre- or postoperative ventilation, whilst early-onset cases were intubated immediately. Oxygenation index (OI) was used to assess the severity of persistent pulmonary hypertension. It is calculated by the following equation: MAP × FiO2 × 100 ÷ PaO2. Babies having OI <5 are considered to have mild pulmonary hypertension; thus, thoracoscopic repair was offered for them.
Twenty nine CDH cases met the selection criteria; therefore, they underwent thoracoscopic repair. Seventeen neonates present within the first 48 hours, while only 12 cases showed delayed presentation. The duration of ventilation, time to start enteral feeding was significantly longer in early-onset group. Conversion to open repair occurred in 4 cases, with causes related to surgical factors, and none was due to pure anaesthetic problem or general deterioration during thoracoscopy. Recurrence was discovered in 1 case only and there were no other complications or mortality.