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Delayed surgery for congenital diaphragmatic hernia.
D W Goh1, D P Drake, R J Brereton
1Department of Paediatric Surgery, Hospitals for Sick Children, London, UK.
The British Journal of Surgery
|July 1, 1992
Summary
Intensive resuscitation and delayed surgery for congenital diaphragmatic hernia (CDH) in neonates yield survival rates comparable to urgent repair. This strategy allows avoiding surgery in most neonates who would not survive.
Area of Science:
- Pediatric Surgery
- Neonatal Care
- Critical Care Medicine
Background:
- Congenital diaphragmatic hernia (CDH) is a severe condition in neonates.
- Early diagnosis and intervention are crucial for survival.
Purpose of the Study:
- To evaluate the outcomes of intensive resuscitation with controlled, delayed operation for neonatal congenital diaphragmatic hernia.
- To compare long-term results with urgent operative repair.
Main Methods:
- Retrospective analysis of 67 neonates treated for CDH between 1987 and 1990.
- Categorization based on preoperative stabilization success.
Main Results:
- Overall mortality rate was 33%.
- 47 neonates achieved preoperative stabilization, all surviving initial treatment (2 later deaths).
- 20 neonates could not be stabilized and all died within 3 days (18 without surgery, 2 post-repair).
Conclusions:
- Intensive resuscitation and delayed operation for CDH offer similar long-term survival to urgent repair.
- This approach effectively avoids surgery in neonates with a poor prognosis.