The intrapartum strategy for thoracoscopic repair of congenital diaphragmatic hernia(CDH): five cases report and literature review

Purpose: To introduce a new method of minimally invasive repair of Congenital diaphragmatic hernia intrapartum(CDH). Methods: We present five CDH cases diagnosed prenatally. Each patient was evaluated by a multidisciplinary team and received thoracoscopic defect repair on placental support. The neonates were transferred to NICU for further treatment, and all cases were under follow-up. Results: The patients enrolled were mild to moderate, with thoracic herniation of the liver occurring in one case. All five cases were repaired on placenta support. Maternal morbidity was reported in one case for acute pulmonary embolism (case 2), but no recorded case of maternal mortality. Postoperative neonatal death occurred in two cases (case 2,3), the remaining three neonates are under follow-up with a good prognosis. Conclusion: The intrapartum thoracoscopic repair is feasible and safe for selected CDH cases.