title: Thoracoscopic plication of the diaphragm in infants in the first 3 months of life.
abstract: OBJECTIVE
  Thoracoscopic plication of the diaphragm is an alternative to conventional surgical treatment of diaphragmatic evisceration via thoracotomy in neonates and infants. The aim of this study is to compare results of treatment by these two methods in the past 11 years.
  
  
  METHODS
  We studied the data of 35 neonates who underwent standard posterolateral thoracotomy (18 patients; Group I) or video-assisted thoracoscopic surgery (17 patients; Group II) for diaphragmatic plication. The two groups were compared for patient demographics, operative reports, and postoperative parameters.
  
  
  RESULTS
  The groups were similar in terms of demographics and preoperative parameters. There was a significant difference in mean operative time between the open and thoracoscopic procedure (71.67 minutes versus 51.76 minutes; P<.05). Duration of care in the neonatal intensive unit and length of hospital stay were significantly shorter in Group II (5.89 days versus 3.23 days [P<.05] and 13.06 days versus 9.88 days [P<.05]). Early postoperative complications (hemothorax, pneumothorax) were frequent in the thoracotomy group (Group I) (16.67% versus 0%; P>.05). Recurrence of diaphragmatic evisceration was observed only in the thoracotomy group (11.11% versus 0%; P=.486).
  
  
  CONCLUSIONS
  Thoracoscopic plication of the diaphragm in infants in the first 3 months of life demonstrates better results than open surgery.
authors.affiliation: Department of Neonatal Surgery, Municipal Pediatric Hospital , Irkutsk, Russia .
authors.forename: Yury
authors.initials: Y
authors.lastname: Kozlov
authors.forename: Vladimir
authors.initials: V
authors.lastname: Novozhilov
mesh_terms: D003964:Diaphragm / Q000601:surgery*; D003965:Diaphragmatic Eventration / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay; D008297:Male; D012008:Recurrence; D020775:Thoracic Surgery, Video-Assisted; D013908:Thoracotomy; D016896:Treatment Outcome