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https://doi.org/10.14300/mnnc.2019.14073

Diagnosis and treatment of the congenital diaphragmatig hernia in children: a multicenter research

[Original research] [Surgery]
Maxim Razin; Sergey Minaev; Mikhail Aksel’rov; Victor Tarakanov; Aleksandr Svirsky; Pavel Trushin; Alena Galanina; Natusya Barova; Alexey Gramzin; Maksim Smolensev;

A multicenter study focuses on the diagnosis and treatment of congenital diaphragmatic hernia (CDH) in 434 children from 1999 to 2018. Clinical, laboratory, ultrasound, X-ray and functional methods of research were performed for all patients. The course of CDH was complicated by concomitant pathology with agenesis of the cupula of the diaphragm in all children, with other false CDH – in 66.8 %, with relaxation of the diaphragm dome – in 50.9 %, in hernias of the esophageal hiatus – in 43.3 %. Surgical interventions were performed, including using laparoscopic and thoracoscopic approaches. When replacing defects in the diaphragm, allograft and bioallotransplant materials were used. The greatest number of complications was observed in children with cupula agenesia after alloplasty of the diaphragm. The highest percentage of relapses (5.7 %) was recorded with limited defects of the diaphragm. Lethal cases after surgical correction of a hernia of the esophageal opening of the diaphragm were not noted; high mortality was among the newborns with diaphragm cupula agenesia (94.1 %).

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Keywords: congenital diaphragmatic hernia, diagnosis, operative treatment, children, multicenter research