title: Minimally invasive surgery for diaphragmatic diseases in neonates and infants.
abstract: Owing to recent advances in minimally invasive surgery (MIS), laparoscopic and thoracoscopic surgery have been gradually introduced for use in neonates and infants. This review focuses on two popular MIS procedures for diaphragmatic diseases in neonates and infants: congenital diaphragmatic hernia (CHD) repair and plication for diaphragmatic eventration. While several advantages of MIS are proposed for CDH repair in neonates, there are also some concerns, namely intraoperative hypercapnia and acidosis and a higher recurrence rate than open techniques. Thus, neonates with severe CDH, along with an unstable circulatory and respiratory status, may be unsuitable for MIS repair, and the use of selection criteria is, therefore, important in these patients. It is generally believed that a learning curve is associated with the higher recurrence rate. Contrary to CDH repair, no major disadvantages associated with the use of MIS for diaphragmatic eventration have been reported in the literature, other than technical difficulty. Thus, if technically feasible, all pediatric patients with diaphragmatic eventration requiring surgical treatment are potential candidates for MIS. Due to a shortage of studies on this procedure, the potential advantages of MIS compared to open techniques for diaphragmatic eventration, such as early recovery and more rapid extubation, need to be confirmed by further studies.
authors.affiliation: Department of Pediatric Surgery, Faculty of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan. jfujishi-tky@umin.ac.jp.
authors.forename: Jun
authors.initials: J
authors.lastname: Fujishiro
authors.affiliation: Department of Pediatric Surgery, Faculty of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Ishimaru
authors.affiliation: Department of Pediatric Surgery, Faculty of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Sugiyama
authors.affiliation: Department of Pediatric Surgery, Faculty of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan.
authors.forename: Mari
authors.initials: M
authors.lastname: Arai
authors.affiliation: Division of Surgery, Saitama Children's Medical Center, Magome 2100, Iwatsuki-ku, Saitama, Saitama, 339-8551, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Suzuki
authors.affiliation: Division of Surgery, Saitama Children's Medical Center, Magome 2100, Iwatsuki-ku, Saitama, Saitama, 339-8551, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kawashima
authors.affiliation: Department of Pediatric Surgery, Faculty of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan.|Saitama Children's Medical Center, Magome 2100, Iwatsuki-ku, Saitama, Saitama, 339-8551, Japan.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Iwanaka
mesh_terms: D000138:Acidosis; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003965:Diaphragmatic Eventration / Q000473:pathology / Q000601:surgery*; D005260:Female; D065630:Hernias, Diaphragmatic, Congenital / Q000473:pathology / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D006935:Hypercapnia; D007223:Infant; D007231:Infant, Newborn; D007431:Intraoperative Complications; D010535:Laparoscopy / Q000379:methods; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D013906:Thoracoscopy / Q000379:methods; D016896:Treatment Outcome
keywords: Congenital diaphragmatic hernia; Diaphragmatic eventration; Minimally invasive surgery; Thoracoscopic surgery