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内镜手术与开放手术修复新生儿膈疝的临床结局比较。

A comparison of clinical outcomes between endoscopic and open surgery to repair neonatal diaphragmatic hernia.

作者信息

Lishuang Ma, Yandong Wei, Shuli Liu, Cuiru Feng, Yue Zhang, Ying Wang, Yanxia Zhang, Bin Sun, Jingna Li, Long Li

机构信息

Department of Pediatric Surgery, Capital Instiute of Pediatrics-Peking University Teaching Hospital; Department of Graduate School, Peking Union Medical College, Beijing, People's Republic of China.

Department of Pediatric Surgery, Capital Instiute of Pediatrics-Peking University Teaching Hospital, Beijing, People's Republic of China.

出版信息

J Minim Access Surg. 2017 Jul-Sep;13(3):182-187. doi: 10.4103/jmas.JMAS_208_16.

DOI:10.4103/jmas.JMAS_208_16
PMID:28607284
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5485806/
Abstract

OBJECTIVE

The objective of this study is to evaluate the clinical efficacies of open versus endoscopic surgery in the treatment of congenital diaphragmatic hernia (CDH) and investigate the feasibility and safety of endoscopic surgery as an alternative to open surgery in these cases.

PATIENTS AND METHODS

A retrospective analysis was performed from June 2002 to February 2014. A total of 59 cases were attempted. The neonates were divided into either an endoscopic or open surgery group. The pre-, intra- and post-operative data on the neonates were analysed, and the surgery-related complications, survival rates and recurrence rates were compared between the two groups.

RESULTS

Demographic characteristics were not significantly different between the two groups. Compared with open group, the hospital stay and post-operative mechanical ventilation time were significantly shorter, while surgery duration was significantly longer in the endoscopic surgery group. The recurrence rate was higher and the survival rate was lower in the endoscopic surgery group with no statistically significant and the recurrence rate has decreased over the past 5 years.

CONCLUSIONS

We have demonstrated that the endoscopic surgery is safe and effective for repairing CDH. The endoscopic surgery is a minimally invasive procedure with fast post-operative recovery and a good cosmetic outcome.

摘要

目的

本研究旨在评估开放手术与内镜手术治疗先天性膈疝（CDH）的临床疗效，并探讨内镜手术作为这些病例中开放手术替代方案的可行性和安全性。

患者与方法

对2002年6月至2014年2月期间进行回顾性分析。共尝试了59例病例。将新生儿分为内镜手术组或开放手术组。分析了新生儿术前、术中和术后的数据，并比较了两组之间与手术相关的并发症、生存率和复发率。

结果

两组的人口统计学特征无显著差异。与开放手术组相比，内镜手术组的住院时间和术后机械通气时间明显缩短，而手术时间明显延长。内镜手术组的复发率较高，生存率较低，但无统计学意义，且在过去5年中复发率有所下降。

结论

我们已经证明内镜手术修复CDH是安全有效的。内镜手术是一种微创手术，术后恢复快，美容效果好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f26/5485806/9a13094ba776/JMAS-13-182-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f26/5485806/3054c9ce1410/JMAS-13-182-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f26/5485806/972d12ee6929/JMAS-13-182-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f26/5485806/9a13094ba776/JMAS-13-182-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f26/5485806/3054c9ce1410/JMAS-13-182-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f26/5485806/972d12ee6929/JMAS-13-182-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f26/5485806/9a13094ba776/JMAS-13-182-g004.jpg

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