{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T06:36:11Z","timestamp":1789022171713,"version":"build-2803163510"},"reference-count":26,"publisher":null,"issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>There are no standard criteria to select patients for thoracoscopic repair of congenital diaphragmatic hernia (CDH). The objective of this study was to compare open laparotomy versus thoracoscopic repair of CDH in neonates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods:<\/jats:title>\n                    <jats:p>\n                      This retrospective study included 41 patients who had repair of CDH from 2011 to 2019. Patients were divided into two groups according to the surgical approach; open laparotomy (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 30) and thoracoscopic repair (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 11). Study endpoints were duration of post-operative mechanical ventilation, hospital stay and the return to full enteral feeding.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Patients who had thoracoscopic repair were significantly younger (3 [25\n                      <jats:sup>th<\/jats:sup>\n                      - 75\n                      <jats:sup>th<\/jats:sup>\n                      percentiles: 3-3] vs. 4 [3\u20135] days;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.004). Other pre-operative variables were comparable between both groups. The duration of surgery was significantly longer in the thoracoscopic repair (174 [153\u2013186] vs. 91 (84\u201399) min;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). The use of pre-operative nitrous oxide inhalation was associated with prolonged ventilation (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.004), while the thoracoscopic repair was associated with shorter mechanical ventilation (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.006). Hospital stay is lower in the thoracoscopic approach but did not reach a significant value (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.059). The use of pre-operative nitrous oxide was associated with a prolonged hospital stay (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.002). Younger age (HR: 1.33,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.014) and open approach (HR: 3.56,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.004) were significantly associated with delayed feeding.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The thoracoscopic approach is safe and effective for repairing the CDH. It is associated with shorter mechanical ventilation and rapid return to enteral feeding. Proper patient selection is essential to achieve good outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ajps.ajps_76_20","type":"journal-article","created":{"date-parts":[[2021,2,16]],"date-time":"2021-02-16T05:36:44Z","timestamp":1613453804000},"page":"18-23","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":19,"title":["Congenital Diaphragmatic Hernia in Neonates"],"prefix":"10.67481","volume":"18","author":[{"given":"Osama Abdullah","family":"Bawazir","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdullah","family":"Bawazir","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":null,"reference":[{"key":"R1-5-20240829","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s00383-015-3794-9","article-title":"Congenital diaphragmatic hernia, management in the newborn","volume":"31","author":"McHoney","year":"2015","journal-title":"Pediatr Surg Int"},{"key":"R2-5-20240829","doi-asserted-by":"crossref","first-page":"2120","DOI":"10.1161\/CIRCULATIONAHA.108.845909","article-title":"Antenatal sildenafil treatment attenuates pulmonary hypertension in experimental congenital diaphragmatic hernia","volume":"123","author":"Luong","year":"2011","journal-title":"Circulation"},{"key":"R3-5-20240829","doi-asserted-by":"crossref","first-page":"488","DOI":"10.1016\/j.jpedsurg.2012.09.060","article-title":"Congenital diaphragmatic hernia: An evaluation of risk factors for failure of thoracoscopic primary repair in neonates","volume":"48","author":"Gomes Ferreira","year":"2013","journal-title":"J Pediatr Surg"},{"key":"R4-5-20240829","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1750-1172-7-1","article-title":"Congenital diaphragmatic hernia","volume":"7","author":"Tovar","year":"2012","journal-title":"Orphanet J Rare Dis"},{"key":"R5-5-20240829","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1097\/SLA.0b013e3181dca0e8","article-title":"Neonatal endosurgical congenital diaphragmatic hernia repair: A systematic review and meta-analysis","volume":"252","author":"Lansdale","year":"2010","journal-title":"Ann Surg"},{"key":"R6-5-20240829","doi-asserted-by":"crossref","first-page":"954","DOI":"10.1089\/lap.2015.0243","article-title":"Thoracoscopic CDH repair A survey on opinion and experience among IPEG members","volume":"25","author":"Lacher","year":"2015","journal-title":"J Laparoendosc Adv Surg Tech A"},{"key":"R7-5-20240829","doi-asserted-by":"crossref","first-page":"1563","DOI":"10.1016\/S0022-3468(03)00564-5","article-title":"Early experience with minimally invasive repair of congenital diaphragmatic hernias: Results and lessons learned","volume":"38","author":"Arca","year":"2003","journal-title":"J Pediatr Surg"},{"key":"R8-5-20240829","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1055\/s-0032-1329532","article-title":"Minimal access surgery for repair of congenital diaphragmatic hernia: Is it advantageous. 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