Evidence map›Paper›PMID 42014582›Full record

SynthesisPediatric surgery international2026

Thoracoscopic versus open congenital diaphragmatic hernia repair: a systematic review and meta-analysis by the Pediatric Surgery Meta-Analysis Study Group (PESMA).

Sonia Pérez-Bertólez, Mustafa Azizoglu, Sergey Klyuev, Federica Pederiva, Maria Escolino, Batool Sami, Bahattin Aydogdu, Cecilia Gigena Heitsman, Ciro Esposito, Annika Mutanen and 5 more

Abstract readSystematic ReviewMeta-AnalysisComparative Study
PubMed Publisher
In one paragraph

Synthesis in Pediatric surgery international, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Sonia Pérez-BertólezPediatric Urology Unit, Department of Pediatric Surgery, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain. spbertolez@yahoo.es.
Mustafa AzizogluDepartment of Pediatric Surgery, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey.
Sergey KlyuevDepartment of Pediatric Surgery, MEDSI Group Hospital, Moscow, Russian Federation.
Federica PederivaPediatric Surgery Unit, Azienda Ospedaliera Universitaria Integrata (AOUI) Verona, Verona, Italy.
Maria EscolinoDepartment of Translational Medical Sciences, University of Naples Federico II, Naples, Italy.
Batool SamiFaculty of Medicine, Department of Pediatric Surgery, Alexandria University, Alexandria, Egypt.
Bahattin AydogduDepartment of Pediatric Surgery, Balikesir University, Balikesir, Turkey.
Cecilia Gigena HeitsmanDepartment of Pediatric Surgery, Mother and Child Medical Center, Fundación Hospitalaria, Cleveland, USA.
Ciro EspositoDepartment of Translational Medical Sciences, University of Naples Federico II, Naples, Italy.
Annika MutanenDepartment of Pediatric Surgery, The New Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
Sameh ShehataFaculty of Medicine, Department of Pediatric Surgery, Alexandria University, Alexandria, Egypt.
Andrea ConfortiMedical and Surgical Department of the Fetus, Newborn and Infant, Bambino Gesù Children's Hospital IRCCS, Rome, Italy.
Martin LacherDepartment of Pediatric Surgery, University Hospital Leipzig, Leipzig, Germany.
Oliver MuenstererDepartment of Pediatric Surgery, Dr. von Hauner Children's Hospital, LMU Klinikum, Munich, Germany.
Fabio ChiarenzaDepartment of Pediatric Surgery, Pediatric Minimally Invasive Surgery and New Technologies, San Bortolo Hospital, Vicenza, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo compare outcomes of thoracoscopic repair (TR) versus conventional open repair (COR) for congenital diaphragmatic hernia (CDH) through a systematic review and meta-analysis.

methodsPubMed, EMBASE, SCOPUS, and Web of Science were searched up to August 2025 for comparative neonatal CDH studies. Randomized, prospective, and retrospective designs reporting at least one clinical outcome were included. Risk ratios (RR) with 95% confidence intervals (CI) were pooled using a random-effects model. The review followed PRISMA guidelines and was registered in PROSPERO (CRD420251128490).

resultsNineteen studies involving 434 TR and 631 COR cases were included. Total recurrence was higher after TR (12.9% vs. 4.1%; RR 2.40; p = 0.0003). Primary repair recurrence showed the largest difference (12% vs. 0%; RR 4.39; p = 0.001), and patch repair recurrence remained higher in TR (21% vs. 11.5%; RR 1.98; p = 0.04). Bowel obstruction was lower after TR (6% vs. 14.6%; RR 0.52; p = 0.02). No significant differences were found for chylothorax, pneumothorax, pleural effusion, or bowel injury. Mortality was lower in TR (0.9% vs. 5.9%; RR 0.31; p < 0.0001), likely reflecting patient selection.

conclusionTR is feasible in selected neonates and is associated with lower bowel obstruction and mortality but higher recurrence. Standardized criteria for selecting TR versus COR remain essential.

Indexed as

Hernias, Diaphragmatic, CongenitalHerniorrhaphyThoracoscopyHumansInfant, NewbornRecurrenceTreatment OutcomeCongenital diaphragmatic herniaOpen repairThoracoscopy

Identifiers

PMID42014582

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.