Advances in the surgical approach to congenital diaphragmatic hernia

Augusto Zani; Elke Zani-Ruttenstock; Agostino Pierro

doi:10.1016/j.siny.2014.09.002

Advances in the surgical approach to congenital diaphragmatic hernia

Semin Fetal Neonatal Med. 2014 Dec;19(6):364-9. doi: 10.1016/j.siny.2014.09.002. Epub 2014 Nov 11.

Authors

Augusto Zani¹, Elke Zani-Ruttenstock¹, Agostino Pierro²

Affiliations

¹ Division of General and Thoracic Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada.
² Division of General and Thoracic Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada. Electronic address: agostino.pierro@sickkids.ca.

PMID: 25447986
DOI: 10.1016/j.siny.2014.09.002

Abstract

Congenital diaphragmatic hernia is a birth defect that affects about one in 2500 live births. Although the overall survival has improved over the last several decades thanks to advancements in postnatal resuscitation and intensive care treatment, morbidity and mortality remain high. The surgical management of these infants is far from being standardized, and many aspects are still disputed among experts. The timing of surgical repair remains controversial and the indications for the ideal time for surgery have not been validated. The main novelty in the surgical treatment is related to the use of minimally invasive techniques, although these have been associated with intraoperative blood gas disturbances and higher recurrence rates. Herein, we report and comment on the main controversies of postnatal CDH repair in this rapidly evolving field.

Keywords: Congenital diaphragmatic hernia; Laparoscopy; Minimally invasive surgery; Muscle flap; Patch; Thoracoscopy.

Publication types

Review

MeSH terms

Hernias, Diaphragmatic, Congenital / surgery*
Humans
Infant
Laparoscopy*