Thoracoscopic Versus Open Repair of Congenital Diaphragmatic Hernia: A Retrospective Case Series From a Tertiary Care Center

Background: Congenital diaphragmatic hernia (CDH) remains a challenging neonatal surgical condition associated with significant morbidity and mortality. Thoracoscopic repair has emerged as a minimally invasive alternative to conventional open repair in selected patients. Aim: The aim of this study is to share our experience in the surgical management of CDH and to compare postoperative outcomes between thoracoscopic repair and open laparotomy. Materials and methods: A retrospective analysis of six patients with CDH managed surgically at a tertiary care center was performed. Demographic data, antenatal diagnosis, pulmonary arterial hypertension (PAH), surgical approach, ventilator requirement, initiation of enteral feeding, duration of analgesia, hospital stay, and follow-up outcomes were evaluated. Results: All patients had left-sided Bochdalek hernias. Three patients underwent thoracoscopic repair, and three underwent open laparotomy. Thoracoscopic repair was associated with a reduced ventilator requirement, earlier initiation of enteral feeds, shorter duration of intravenous analgesia, and reduced hospital stay. One mortality occurred in the laparotomy group. No patient required extracorporeal membrane oxygenation (ECMO) or patch repair. Conclusion: Thoracoscopic repair of CDH, when performed in carefully selected patients, is safe and associated with improved short-term postoperative outcomes compared to open repair.