title: Thoracoscopic treatment of congenital diaphragmatic eventration in children: lessons learned after 15 years of experience.
abstract: BACKGROUND
  We present our experience with the thoracoscopic treatment of congenital diaphragmatic eventration (CDE) in children through 15 years to evaluate the efficiency of the procedure and the potential risk of recurrence. Materials and
  
  
  METHODS
  We reviewed the medical files of patients treated for CDE through thoracoscopy from 2000 to 2011. Age at surgery, sex, side of the lesion, procedure's details, postoperative course, and complications were analyzed. Mean follow-up was 12 months.
  
  
  RESULTS
  In this study, eight patients (five males and three females) aged from 6 months to 7 years underwent thoracoscopic plication for six right and two left eventrations; one conversion was necessary due to a too small operative field. Mean operative time was 60.5 minutes. A chest drainage was placed in six patients. We observed two recurrences from which the first one was treated thoracoscopically by endostapler resection/suturing and the other one by laparotomy. At follow-up, all patients were asymptomatic with a correct level of the diaphragm.
  
  
  CONCLUSIONS
  Thoracoscopic plication is feasible and safe, and we consider this approach as the gold standard for the treatment of CDE. However, we still need to carefully consider the possibility of introducing certain modifications to reduce the potential risk of recurrence.
authors.affiliation: Department of Medical and Surgical Pediatric Sciences, Unit of Pediatric Surgery, University of Messina, Messina, Italy.
authors.forename: Francesca Astra
authors.initials: FA
authors.lastname: Borruto
authors.affiliation: Department of Pediatric Surgery, Hopital de Hautepierre, Les Hopitaux Universitaire de Strasbourg, Strasbourg Cedex, France.
authors.forename: Cindy Gomes
authors.initials: CG
authors.lastname: Ferreira
authors.affiliation: Department of Pediatric Surgery, Hopital de Hautepierre, Les Hopitaux Universitaire de Strasbourg, Strasbourg Cedex, France.
authors.forename: Christos
authors.initials: C
authors.lastname: Kaselas
authors.affiliation: Department of Pediatric Surgery, Hopital de Hautepierre, Les Hopitaux Universitaire de Strasbourg, Strasbourg Cedex, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Schneider
authors.affiliation: Department of Pediatric Surgery, Hopital de Hautepierre, Les Hopitaux Universitaire de Strasbourg, Strasbourg Cedex, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Lacreuse
authors.affiliation: Department of Pediatric Surgery, Hopital de Hautepierre, Les Hopitaux Universitaire de Strasbourg, Strasbourg Cedex, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Kauffmann
authors.affiliation: Department of Pediatric Surgery, Hopital de Hautepierre, Les Hopitaux Universitaire de Strasbourg, Strasbourg Cedex, France.
authors.forename: Raphael
authors.initials: R
authors.lastname: Moog
authors.affiliation: Department of Pediatric Surgery, Hopital de Hautepierre, Les Hopitaux Universitaire de Strasbourg, Strasbourg Cedex, France.
authors.forename: François
authors.initials: F
authors.lastname: Becmeur
mesh_terms: D002648:Child; D002675:Child, Preschool; D003965:Diaphragmatic Eventration / Q000601:surgery*; D004322:Drainage; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D061646:Operative Time; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D017792:Surgical Stapling; D013906:Thoracoscopy / Q000379:methods*