Possibilities and limits in the treatment of congenital diaphragmatic hernia.

AIM: to establish a therapeutic strategy that will improve the prognosis and increase the survival rate in congenital diaphragmatic hernia.

MATERIAL AND METHOD: 14 congenital diaphragmatic hernias (incidence 1/1597 live births, 12 boys and 2 girls with a sex ratio of 6/1, 10 term infants and 4 preterm first degree, 11 natural births and 3 by caesarean section) admitted to the Clinic of Pediatric Surgery Craiova, in a 5-year period (2007-2012), were analyzed from the therapeutic point of view. The "tension free" primary suture was the main surgical procedure to repair the diaphragmatic defect in all cases, preceded by a period of preoperative resuscitation and stabilization (2.8 days on average).

RESULTS

We registered a survival rate of 64.29% and a postoperative mortality rate of 35.71%.

CONCLUSIONS

delayed surgery preceded by a period of the preoperative respiratory resuscitation and stabilization (24-72 hours on average) significantly reduced postoperative mortality and increased the survival rate.