EXPERIENCE OF TREATMENT OF CONGENITAL DIAPHRAGMATIC HERNIA AMONG BABIES

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.