Minimally Invasive Approaches to Congenital Diaphragmatic Hernias

摘要: Congenital diaphragmatic hernia (CDH) results in life-threatening pulmonary hypoplasia and hypertension. Surgical repair is indicated all CDH patients after stabilization of the respiratory status, as determined by specific physiologic criteria. Most are candidates for thoracoscopic repair, though limiting CO2 insufflation to 4–5 mmHg suggested labile patients. An initial rise end-tidal expected, prolonged hypercarbia may prompt conversion open procedure. Repair performed using three ports. Abdominal contents reduced into viscera, defect repaired either a primary approach or bioprosthetic patch larger defects. The concern recurrence. Though rates recurrence have historically been higher incidence decreases with experience. Other complications include postoperative pneumothorax, musculoskeletal-skeletal deformity, bowel obstruction. advent ECMO improved neonatal care has significantly prognosis up 90 % survival at major referral centers.