Current surgical management of congenital diaphragmatic hernia: A report from the congenital diaphragmatic hernia study group

Congenital diaphragmatic hernia: a systematic review and summary of best-evidence practice strategies

“…The literature, including these combined reports, now supports the view that surgical repair of CDH should be performed on an elective basis, when the patient has been stabilized medically. 1,60,61 The improvements in survival noted in serial epochs of care at these centers supports the notion, particularly in infants with moderateto high-risk CDH, that these strategies are best avoided. While there is variation in reporting patterns, some consideration should be given to hidden mortality when evaluating CDH survival statistics, and it is important to acknowledge the potential for bias in reports with historical controls.…”

“…1 The combination of pathophysiologic derangements associated with CDH, including lung hypoplasia, lung dysmaturity and pulmonary hypertension (PPHN), requires a multidisciplinary approach to care. 2,3 The complex nature of clinical management and the relatively infrequent presentation of infants with this rare malformation to single centers has lead to difficulty identifying consistent strategies for CDH management.…”

“…Keywords: congenital diaphragmatic hernia; pulmonary hypertension; pulmonary hypoplasia; inhaled nitric oxide; extracorporeal membrane oxygenation; systematic review Introduction Congenital diaphragmatic hernia (CDH) is a rare malformation observed in approximately 1 in 3000 live births, with estimates of postnatal survival ranging from 50 to 70% despite advances in neonatal care. 1 The combination of pathophysiologic derangements associated with CDH, including lung hypoplasia, lung dysmaturity and pulmonary hypertension (PPHN), requires a multidisciplinary approach to care. 2,3 The complex nature of clinical management and the relatively infrequent presentation of infants with this rare malformation to single centers has lead to difficulty identifying consistent strategies for CDH management.…”

The long-term follow-up of patients with a congenital diaphragmatic hernia: a broad spectrum of morbidity

“…Delayed surgery is theorized to provide additional time for remodeling of the pulmonary vasculature, leading to a more stable infant, who is better able to tolerate a postoperative decrease in compliance [16,19]. Although a significant change in survival after the introduction of delayed surgery was not observed [4,[20][21][22], a strategy of delaying correction of the defect for some period of time have been adopted by centers, with the majority of patients undergoing operation beyond 24 h of age [23,24].…”

Heparinized collagen scaffolds with and without growth factors for the repair of diaphragmatic hernia

“…Patch materials commonly applied include polytetrafluoroethylene (PTFE) 1 and small intestinal submucosa (SIS), derived from decellularised porcine submucosa. 2 Both types of materials have been found successful in some studies, [3][4][5] but showed high recurrence rates in others.…”