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EXPERIENCE OF TREATMENT OF CONGENITAL DIAPHRAGMATIC HERNIA AMONG BABIES
Insights
This study improved congenital diaphragmatic hernia treatment in infants using advanced ventilation and minimally invasive surgery. Outcomes show reduced mortality and excellent functional results, emphasizing prenatal diagnosis.
Area of Science:
- Pediatric Surgery
- Neonatal Care
- Thoracic Surgery
Background:
- Congenital diaphragmatic hernia (CDH) presents significant challenges in neonates.
- Esophageal hiatus hernia is common in early childhood.
- Previous treatment strategies had limitations in managing these conditions.
Purpose of the Study:
- To present updated surgical tactics for CDH and esophageal hiatus hernia in children.
- To evaluate the effectiveness of a modified treatment protocol.
- To improve patient outcomes and reduce mortality rates.
Main Methods:
- Implementation of prolonged preoperative preparation with high-frequency lung ventilation.
- Correction of pulmonary hypertension symptoms.
- Surgical intervention via low-invasive endosurgery after patient stabilization.
- Emphasis on antenatal and prenatal diagnosis of lung hypoplasia using fetal pulmonary and head index.
Main Results:
- 25 children successfully operated in the last 5 years with good functional and cosmetic results.
- Lethality for congenital diaphragmatic hernia in newborns decreased to 12%.
- No postoperative lethality observed in recent cases.
Conclusions:
- The revised treatment protocol, including advanced preoperative care and minimally invasive surgery, has significantly improved outcomes for CDH.
- Antenatal diagnosis and assessment of lung hypoplasia are crucial for managing high-risk neonates.
- The current approach demonstrates a marked reduction in mortality and excellent recovery for pediatric diaphragmatic hernias.
Abstract:
The article presents our experience of treatment of congenital diaphrogmatic hernia at newborns and hernia of an esophageal opening of a diaphragm among children of early age. Since 2010 surgical tactics has been changed: the prolonged preoperative preparation with use of the device of high-frequency ventilation of lungs, correction of symptoms of pulmonary hypertensia is carried out, operation is carried out according to plan after stabilization of the patient in parameters of oxygenation and an acid-base state, operative treatment is executed by method of low-invasive endosurgery. Over the last 5 years 25 children with good functional and cosmetic results have been operated. The lethality in the case of congenital diaphragmatic hernia at newborns decreased to 12%, it was noted generally among patients with the expressed hypoplasia of lungs which died during preoperative preparation. In recent years we place emphasis on antenatal diagnosis of pathology and prenatal diagnostics of degree of a hypoplasia of a lung on indicators of a pulmonary and head index at a fetus. It wasn't noted a postoperative lethality.
