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Purpose: To analyze the clinical outcome of thoracoscopic repair of neonatal congenital diaphragmatic hernia(CDH)with standardized indications.Methods: Clinical data of 14 neonates with CDH underwent thoracoscopic repair from September 2013 to August 2014 were retrospectively analyzed.Selection criteria: weight beyond 2.0kg; liver in the abdomen; no intestinal obstruction; no severe cardiopulmonary anomalies; not required high frequency oscillatory ventilation or extracorporeal membrane oxygenation.Timing of surgery: mean arterial blood pressure normal for gestational age; preductal saturation levels of 85 to 95%on fractional inspired oxygen below 50%; lactate below 3 mmol/l; urine output more than 2 ml/kg/h.Fourteen cases in historical control group who underwent open repair with the same physiological status were reviewed for comparison.Results: Demographic features were similar between thoracoscopic repair(TR)group and open repair(OR)group.There were statistically significant differences in intraoperative mean PaCO2(48 ± 8 mmHg vs 39 ± 6 mmHg,P=.002)and mean pH(7.30±0.06 vs 7.39±0.06,P=.000)in arterial blood gas test but lactate(0.93±0.16 mmol/L vs 0.98±0.14 mmol/L,P=.387)did not differ between groups.Longer operation time was found in TR group(116±27 min vs 74±25 min,P=.000).There were no significant differences in mean ventilator time(113±51 hr vs 100±63 hr,P=.554).No recurrence was observed in groups within the first year of life follow-up.Conclusions: With selection criteria and timing,thoracoscopic repair of CDH in neonates can be performed safely and successfully.