Department of Pediatric Surgery, John Hopkins All Children's Hospital, St. Petersburg, Florida, USA.
Department of Pediatric Surgery, Akron Children's Hospital, Akron, Ohio, USA.
J Laparoendosc Adv Surg Tech A. 2021 Oct;31(10):1168-1174. doi: 10.1089/lap.2021.0420. Epub 2021 Sep 27.
Congenital diaphragmatic hernia (CDH) is a relatively common congenital anomaly, typically requiring repair in the neonatal period. Approaches to surgical repair of a CDH are varied. A small defect may be repaired primarily while a large defect often requires a patch repair. Minimally invasive and open techniques have been reported to have varying benefits and outcomes. The authors describe their technique of CDH repair and present a review of the literature. In a stabilized neonate with a small-to-moderate CDH defect, a thoracoscopic primary repair with biological mesh underlay (or a patch repair if needed to reduce tension) represents our approach of choice to treat this pathology. However, attention to specific technical details is required to minimize incidence of recurrence. The data favor a minimally invasive approach to CDH repair in the appropriate patients.
先天性膈疝 (CDH) 是一种相对常见的先天性畸形，通常需要在新生儿期进行修复。CDH 的手术修复方法多种多样。小的缺损可以直接修复，而大的缺损通常需要补片修复。已经报道了微创和开放技术具有不同的益处和结果。作者描述了他们的 CDH 修复技术，并对文献进行了回顾。对于稳定的新生儿，伴有小至中度 CDH 缺损，我们选择使用生物补片在胸腔镜下进行一期直接修复（或在需要减少张力时进行补片修复）来治疗这种疾病。然而，需要注意具体的技术细节，以尽量减少复发的发生率。数据支持在合适的患者中采用微创方法进行 CDH 修复。
