Diaphragmatic hernia surgery
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Diaphragmatic hernia Main page |
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Treatment |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Ahmed Younes M.B.B.CH [2]
Overview
Surgical intervention is the mainstay of management of diaphragmatic hernia. The repair can be primary (using sutures to seal the defect) or patch closure (using a prosthetic or fascial patch to close the defect).
Surgical treatment
- The procedure must not be done unless the infant is stable.[1]
- Most of the operations are done through a subcostal incision.
- The repair can be done in one of two ways depending on its size:[2]
- Primary closure: it involves repairing the defect using non-absorbable sutures. It is used if the defect is relatively small.
- Patch closure: using a prosthetic or fascial patch to close the defect. It is useful especially with large defects but increases the risk of infection.
- Endoscopic procedures through the thorax or the abdomen have been reported to have lower mortality rates but have higher recurrence rates.[3]
- If CDH repair is associated with an abdominal wall defect, silo closure may be tried temporarily until the CDH is stabilized.[4]
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References
- ↑ Clark RH, Hardin WD, Hirschl RB, Jaksic T, Lally KP, Langham MR, Wilson JM (1998). "Current surgical management of congenital diaphragmatic hernia: a report from the Congenital Diaphragmatic Hernia Study Group". J. Pediatr. Surg. 33 (7): 1004–9. PMID 9694085.
- ↑ Chandrasekharan PK, Rawat M, Madappa R, Rothstein DH, Lakshminrusimha S (2017). "Congenital Diaphragmatic hernia - a review". Matern Health Neonatol Perinatol. 3: 6. doi:10.1186/s40748-017-0045-1. PMC 5356475. PMID 28331629.
- ↑ Haroon J, Chamberlain RS (2013). "An evidence-based review of the current treatment of congenital diaphragmatic hernia". Clin Pediatr (Phila). 52 (2): 115–24. doi:10.1177/0009922812472249. PMID 23378478.
- ↑ Shue EH, Miniati D, Lee H (2012). "Advances in prenatal diagnosis and treatment of congenital diaphragmatic hernia". Clin Perinatol. 39 (2): 289–300. doi:10.1016/j.clp.2012.04.005. PMID 22682380.