Congenital diaphragmatic hernia surgery: Difference between revisions
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{{Congenital diaphragmatic hernia}} | {{Congenital diaphragmatic hernia}} | ||
{{CMG}} | {{CMG}}; '''Associate Editor(s)-in-Chief:''' [[User:AroojNaz|Arooj Naz, M.B.B.S]] | ||
==Overview== | ==Overview== | ||
Minimally invasive surgery has become preferred method of treatment, which can be done thoracoscopically. Such techniques also lead to reduced postoperative pain and potential complications that may be seen with more invasive surgeries. | |||
==Surgery== | ==Surgery== | ||
* '''Morgagni's Hernia''': In asymptomatic individuals laparoscopic surgical repair is still recommended as they are at risk of a strangulated intestine. | Unlike in the past, surgical repair is now delayed to at least 48 to 72 hours after birth. This allows the pulmonary vasculature to adapt and leads to the reduction of pulmonary hypertension. If ECMO is required, survival rates decrease by 50%. <ref name="pmid32310536">{{cite journal| author=| title=StatPearls | journal= | year= 2022 | volume= | issue= | pages= | pmid=32310536 | doi= | pmc= | url= }}</ref> | ||
* '''Diaphragm Eventration''': Plication basically involves a folding of the eventrated diaphragm which is then sutured in order to “take up the slack” of the excess diaphragm tissue. | |||
* ECMO results in higher rates of bleeding related complications; this may be reduced by aminocaproic acid and modified anticoagulation use | |||
* Complications of ECMO: air embolism, intracranial hemorrhage, seizures, DIC, PDA (in an attempt to reduce pulmonary hypertension) <ref name="pmid20301533">{{cite journal| author=Adam MP, Ardinger HH, Pagon RA, Wallace SE, Bean LJH, Gripp KW | display-authors=etal| title=GeneReviews® | journal= | year= 1993 | volume= | issue= | pages= | pmid=20301533 | doi= | pmc= | url= }}</ref> | |||
*'''Morgagni's Hernia''': In asymptomatic individuals laparoscopic surgical repair is still recommended as they are at risk of a strangulated intestine. | |||
*'''Diaphragm Eventration''': Plication basically involves a folding of the eventrated diaphragm which is then sutured in order to “take up the slack” of the excess diaphragm tissue. | |||
==References== | ==References== |
Revision as of 09:26, 23 April 2022
Congenital diaphragmatic hernia Microchapters |
Differentiating Congenital diaphragmatic hernia from Other Diseases |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Arooj Naz, M.B.B.S
Overview
Minimally invasive surgery has become preferred method of treatment, which can be done thoracoscopically. Such techniques also lead to reduced postoperative pain and potential complications that may be seen with more invasive surgeries.
Surgery
Unlike in the past, surgical repair is now delayed to at least 48 to 72 hours after birth. This allows the pulmonary vasculature to adapt and leads to the reduction of pulmonary hypertension. If ECMO is required, survival rates decrease by 50%. [1]
- ECMO results in higher rates of bleeding related complications; this may be reduced by aminocaproic acid and modified anticoagulation use
- Complications of ECMO: air embolism, intracranial hemorrhage, seizures, DIC, PDA (in an attempt to reduce pulmonary hypertension) [2]
- Morgagni's Hernia: In asymptomatic individuals laparoscopic surgical repair is still recommended as they are at risk of a strangulated intestine.
- Diaphragm Eventration: Plication basically involves a folding of the eventrated diaphragm which is then sutured in order to “take up the slack” of the excess diaphragm tissue.