Zani Augusto, Zani-Ruttenstock Elke, Pierro Agostino
Division of General and Thoracic Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada.
Division of General and Thoracic Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada.
Semin Fetal Neonatal Med. 2014 Dec;19(6):364-9. doi: 10.1016/j.siny.2014.09.002. Epub 2014 Nov 11.
Congenital diaphragmatic hernia is a birth defect that affects about one in 2500 live births. Although the overall survival has improved over the last several decades thanks to advancements in postnatal resuscitation and intensive care treatment, morbidity and mortality remain high. The surgical management of these infants is far from being standardized, and many aspects are still disputed among experts. The timing of surgical repair remains controversial and the indications for the ideal time for surgery have not been validated. The main novelty in the surgical treatment is related to the use of minimally invasive techniques, although these have been associated with intraoperative blood gas disturbances and higher recurrence rates. Herein, we report and comment on the main controversies of postnatal CDH repair in this rapidly evolving field.
先天性膈疝是一种出生缺陷,每2500例活产婴儿中约有1例受其影响。尽管由于产后复苏和重症监护治疗的进展,在过去几十年中总体生存率有所提高,但发病率和死亡率仍然很高。这些婴儿的手术管理远未标准化,许多方面在专家之间仍存在争议。手术修复的时机仍然存在争议,理想手术时间的指征尚未得到验证。手术治疗的主要创新与微创技术的使用有关,尽管这些技术与术中血气紊乱和较高的复发率相关。在此,我们报告并评论在这个快速发展的领域中产后先天性膈疝修复的主要争议。