Surgical management of neonates with congenital diaphragmatic hernia.

摘要: Congenital diaphragmatic hernia (CDH) is one of the most challenging and complex pediatric abnormalities to manage, both medically surgically. The care these neonates has seen significant evolution, from previous aggressive ventilation emergent operation current permissive hypercapnea, physiologic stabilization, elective surgical repair, all in less than two decades. These changes have led many centers reporting survival rates near 80%, a dramatic improvement 50% reported 1970s. This review covers principles guiding management CDH neonate, including preoperative operative timing, extracorporeal membrane oxygenation, approach, recurrence. Although clinical challenges remain, multi-institutional collaboration ongoing research efforts will hopefully improve patients.