Surgical repair of bilateral congenital diaphragmatic hernia associated with hepatopulmonary fusion.

Bilateral congenital diaphragmatic hernia (CDH) is a rare congenital anomaly with high neonatal mortality. The condition is rarely associated with hepatopulmonary fusion (HPF). We reported the surgical repair of bilateral CDH in a male infant aged 6 weeks. The patient had herniation of the liver on the right side with HPF in association with anomalous drainage of the right pulmonary vein into the hepatic vein and ventricular septal defect. We approached both sides thoracoscopically; however, the right side required a subcostal incision. We separated the liver from the right lower lung lobe laterally using electrocautery, and the defect was closed with a mesh. The medial portion was left intact to avoid injury of the anomalous pulmonary venous drainage. After 2 weeks, the patients had a surgical repair of the cardiac defects, and the postoperative course was complicated by bleeding and prolonged ventilation. No hernia recurrence was observed after 9 months.