Diaphragmatic hernia surgery: Difference between revisions
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==Overview== | ==Overview== | ||
==== | ==Surgical treatment== | ||
*The procedure must not be done unless the infant is stable.<ref name="pmid9694085">{{cite journal |vauthors=Clark RH, Hardin WD, Hirschl RB, Jaksic T, Lally KP, Langham MR, Wilson JM |title=Current surgical management of congenital diaphragmatic hernia: a report from the Congenital Diaphragmatic Hernia Study Group |journal=J. Pediatr. Surg. |volume=33 |issue=7 |pages=1004–9 |year=1998 |pmid=9694085 |doi= |url=}}</ref> | |||
*Most of the operations are done through a subcostal incision. | |||
*The repair can be done in one of two ways depending on its size:<ref name="pmid28331629">{{cite journal |vauthors=Chandrasekharan PK, Rawat M, Madappa R, Rothstein DH, Lakshminrusimha S |title=Congenital Diaphragmatic hernia - a review |journal=Matern Health Neonatol Perinatol |volume=3 |issue= |pages=6 |year=2017 |pmid=28331629 |pmc=5356475 |doi=10.1186/s40748-017-0045-1 |url=}}</ref> | |||
**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|Endoscopic procedures]] through the [[thorax]] or the [[abdomen]] have been reported to have lower mortality rates but have higher recurrence rates.<ref name="pmid23378478">{{cite journal |vauthors=Haroon J, Chamberlain RS |title=An evidence-based review of the current treatment of congenital diaphragmatic hernia |journal=Clin Pediatr (Phila) |volume=52 |issue=2 |pages=115–24 |year=2013 |pmid=23378478 |doi=10.1177/0009922812472249 |url=}}</ref> | |||
*If CDH repair is associated with an [[abdominal wall defect]], silo closure may be tried temporarily until the CDH is stabilized.<ref name="pmid22682380">{{cite journal |vauthors=Shue EH, Miniati D, Lee H |title=Advances in prenatal diagnosis and treatment of congenital diaphragmatic hernia |journal=Clin Perinatol |volume=39 |issue=2 |pages=289–300 |year=2012 |pmid=22682380 |doi=10.1016/j.clp.2012.04.005 |url=}}</ref> | |||
{{#ev:youtube|aA-fwcH0eoA}} | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
Revision as of 16:39, 22 December 2017
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Diaphragmatic hernia Main page |
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Diagnosis |
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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 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]
{{#ev:youtube|aA-fwcH0eoA}}
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.