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Toracoabdominal access in surgical treatment of congenital left-sided diaphragmal hernas

[Surgery]
Mikhail Chepurnoy; Boris Rosin; Gennady Chepurnoy; Valery Katsupeev; Andrey Kivva; Yury Khoronko; Roman Astakhov; Maksim Kovalyov;

The study includes the results of 159 surgical interventions in newborns with left-sided diaphragmatic hernia, performed in the Pediatric Surgical Clinic of RostSMU for a 35-year period. In 139 patients transabdominal access was performed, in 2 – transthoracic one and in 18 – thoraco-abdominal access. According to the authors, transthoracic access has a number of negative characteristics that turn the operation with this access into a difficult, complex and dangerous surgical intervention due to viscero-abdominal disproportion. Based on the analysis of the work, the authors prefer a thoraco-abdominal access, and thoracotomy should be used only for recurrent diaphragmatic hernia diagnosed in the long-term postoperative period and for diaphragmatic hernia with an initially small amount of abdominal organs located in the pleural cavity.

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References:
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Keywords: congenital diaphragmatic hernias, access, surgery, children


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