{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T19:48:58Z","timestamp":1781552938585,"version":"3.54.5"},"reference-count":20,"publisher":"Georg Thieme Verlag KG","issue":"05","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Eur J Pediatr Surg"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>This study compares various surgical approaches for treating congenital diaphragmatic eventration (CDE) in children to identify the most effective and safest method.<\/jats:p><jats:p>We conducted a retrospective analysis of a multicentric cohort of pediatric patients operated on for CDE between 2010 and 2021. The different surgical approaches, including robot-assisted thoracoscopic surgery (RATS), and their outcomes were compared (Clinical Trials NCT04862494).<\/jats:p><jats:p>One hundred and twelve patients, aged 12 (5\u201321) months, underwent diaphragmatic plication. Thoracoscopy or RATS was performed in 69 (62%) cases, posterolateral thoracotomy (PLT) in 15 (13%), and an abdominal approach in 28 (25%), based on surgeons' choice. Symptom relief was achieved in 88% of patients, and 90% showed radiographic improvement. There were 31 peri- or early postoperative complications (28%), mainly including pleural effusions, infections, and lobar atelectasis, and 8 recurrences of eventration (7%), with no significant correlation between these complications and the surgical approach. Compared to other approaches, thoracotomy multiplied the duration of intravenous analgesia by three (96\u2009h vs. 36\u2009h, p\u2009&lt;\u20090.0001) and hospital stay length by two (8 vs. 4 days, p\u2009=\u20090.002). RATS, although comparable to thoracoscopy in short-term outcomes, had a higher incidence of perioperative hepatic injuries and long-term complications, including persistent symptoms in all five patients and chest wall deformities in two.<\/jats:p><jats:p>Diaphragmatic plication via a minimally invasive thoracic approach may be the best treatment option for cases of symptomatic CDE. Further research is required to establish potential added risks of RATS as compared to thoracoscopy in this indication.<\/jats:p>","DOI":"10.1055\/a-2540-3862","type":"journal-article","created":{"date-parts":[[2025,2,18]],"date-time":"2025-02-18T19:21:36Z","timestamp":1739906496000},"page":"353-361","source":"Crossref","is-referenced-by-count":2,"title":["Comparative Outcomes of Surgical Techniques for Congenital Diaphragmatic Eventration in Children: A Multicenter Retrospective Cohort Analysis"],"prefix":"10.1055","volume":"35","clinical-trial-number":[{"clinical-trial-number":"nct04862494","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3339-3835","authenticated-orcid":false,"given":"Khalid","family":"Alzahrani","sequence":"additional","affiliation":[{"name":"Department of Surgery, Al-Baha University, Alaqiq, Saudi Arabia"},{"name":"Pediatric Surgery Department, Angers University Hospital, Angers, Pays de la Loire, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lymeymey","family":"Heng","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Department, Angers University Hospital, Angers, Pays de la Loire, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naziha","family":"Khen-dunlop","sequence":"additional","affiliation":[{"name":"Departement of Pediatric Surgery, Necker-Enfants malades Hospital, Paris, France"},{"name":"Department of Pediatric Surgery, American Hospital of Paris, Neuilly-sur-Seine, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicoleta","family":"Panait","sequence":"additional","affiliation":[{"name":"Pediatric surgery Department, Marseille Public University Hospital System, Marseille, Provence-Alpes-C\u00f4te d'Azur, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik","family":"Hervieux","sequence":"additional","affiliation":[{"name":"Department of Visceral and Neonatal Pediatric Surgery, H\u00f4pital Armand-Trousseau, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucie","family":"Grynberg","sequence":"additional","affiliation":[{"name":"Department of Pediatric and Adolescent Surgery, Rouen University Hospital, Rouen, Normandy, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4202-4284","authenticated-orcid":false,"given":"Abbo","family":"Olivier","sequence":"additional","affiliation":[{"name":"Service de Chirurgie - Hopital des enfants, CHU Toulouse, Toulouse, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fr\u00e9d\u00e9ric","family":"Hameury","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Department, University Hospital Centre Lyon, Lyon, Auvergne-Rh\u00f4ne-Alpes, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fr\u00e9d\u00e9ric","family":"Lavrand","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Department, University Hospital Centre Bordeaux, Bordeaux, Nouvelle-Aquitaine, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivier","family":"Maillet","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Department, University Hospital of Montpellier, Montpellier, Occitanie, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aurore","family":"Haffreingue","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Department, University Hospital Centre Caen, Caen, Normandie, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3146-9437","authenticated-orcid":false,"given":"Anne","family":"Lehn","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Hopitaux universitaires de Strasbourg, Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan","family":"de Napoli-Cocci","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Department, University Hospital Centre Nantes, Nantes, Pays de la Loire, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edouard","family":"Habonimana","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Department, Rennes University Hospital, Rennes, Bretagne, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Luc","family":"Michel","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Department, Centre Hospitalier Universitaire de La Reunion, Saint-Denis, La R\u00e9union, R\u00e9union"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8357-9609","authenticated-orcid":false,"given":"Louise","family":"Montalva","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Department, Robert-Debr\u00e9 Mother-Child University Hospital, Paris, \u00cele-de-France, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quentin","family":"Ballouhey","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Unit, Centre Hospitalier Universitaire de Limoges, Limoges, Limousin, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arnaud","family":"Fotso Kamdem","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Department, Besan\u00e7on Regional University Hospital Center, Besancon, Bourgogne-Franche-Comt\u00e9, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Fran\u00e7ois","family":"Lecompte","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Department, H\u00f4pitaux P\u00e9diatriques de Nice CHU-LENVAL, Nice, Provence-Alpes-C\u00f4te d'Azu, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoine","family":"Line","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Department, University Hospital Centre Reims, Reims, Grand Est, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Poupalou","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Department, HUDERF, Bruxelles, Bruxelles, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre","family":"Meignan","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Regional University Hospital Centre Tours, Tours, Centre-Val de Loire, 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