Surgery for Diaphragmatic Hernia Repair: A Longitudinal Single-Institutional Experience

Abstract

Background: This study analyzed and described the clinical characteristics and surgical outcomes of diaphragmatic hernia (DH) repair according to the operative approach. Methods: After excluding cases with a combined approach and hiatal hernias, we analyzed 26 patients who underwent DH repair between 1994 and 2018. The baseline and perioperative characteristics of the thoracic approach group and the abdominal approach group were described and analyzed. Results: Fifteen of the 26 patients were treated through the thoracic approach, including 5 patients who underwent video-assisted thoracic surgery (VATS). Eleven patients underwent the abdominal approach. The thoracic approach was associated with a longer duration of DH than the abdominal approach (2 vs. 0.1 months), herniation of the right-sided abdominal organs, and herniation of the retroperitoneal organs. During the median follow-up of 23 months, there was no recurrence of DH. Conclusion:The surgical approach should be chosen considering the duration of DH and the location of herniated organs. VATS might be a safe and feasible option for repairing DH.

Commentary: Is the Data Strong Enough to Prorocolize the Approach in Diaphragmatic Hernia Repair? Aspects of Technique and the Sample Size of a Longitudinal Single-Center Study

“…In this issue of the Journal of Chest Surgery , Oh et al [ 1 ] at Samsung Medical Center present a retrospective cohort study that investigated the clinicopathologic characteristics of patients with diaphragmatic hernia (DH) who underwent different surgical treatment approaches. To date, there are no established criteria for the proper indications and patient selection for the different surgical approaches to DH repair [ 2 ].…”